Health Requirements For School Attendance in New Hampshire









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    STATE OF NEW HAMPSHIRE SCHOOL TOOLKIT FOR CORONAVIRUS DISEASE 2019 (COVID-19) NH Department of Health and Human Services Division of Public Health Services Bureau of Infectious Disease Control -16- COVID-19 School Toolkit

    March 25, 2021, ~ Dear Families:

    We are asking for your help to prevent COVID-19 from impacting our school community.

    COVID-19 is most commonly spread through respiratory droplets when an infected person talks, coughs, sneezes or sings. As a school community we ask for your support to take the following precaution to prevent the spread of the disease: 

    → Keep sick children home and report their illness to the school nurse if your child has a fever or is not feeling well.

    →Know the symptoms of the COVID-19:

    * Fever/chills (measured 100.0F)

    * Cough / Shortness of breath or difficulty breathing

    * Sore throat

    * Runny nose or nasal congestion

    * Muscle or body aches 

    * Fatigue 

    * Headache

    * New loss of taste or smell 

    * Nausea or vomiting

    * Diarrhea

    → Prior to arriving at school, please screen your student for:

    * Any new or unexplained symptoms of COVID-19 (listed above); this includes even mild symptoms. 

    *Close contact with someone who has been diagnosed with COVID-19 in the prior 14 days.

    * International or cruise ship travel in the last 10 days

    → Any person with new or unexplained symptoms of COVID-19 will be excluded from school and instructed to isolate at home and contact their primary care provider for COVID-19 testing.

     Symptomatic students or staff can be allowed to return to school when one of the following two conditions is met:

    1. Person receives an approved COVID-19 test that is negative, AND the person’s symptoms are improving and they are fever-free for at least 24 hours off any fever-reducing medications. *Approved tests include: ⇒ A PCR-based molecular test ⇒ Antigen testing conducted within an appropriate number of days since symptom onset

    2. Person has met CDC criteria for ending of home isolation (i.e., if a person is not tested, it will be presumed that person is positive COVID-19).

    →If a student has close contact with someone diagnosed with COVID-19 by PCR or antigen test in the prior 14 days or has an international or cruise ship travel-related risk, they are required to complete self-quarantine at home for 10 days from the last known exposure.

    Together, with you, we will teach and promote all students to:

    → Frequently wash their hands. Hand washing for 20 seconds with soap and water, or using hand sanitizer that contains at least 60% alcohol, is the best way to reduce the spread of germs.

    → Cover coughs and sneezes with a tissue or their elbow. And to wash their hands or use hand sanitizer once they discard of the tissue. 

    → Not to share personal items such as drinks, food, or water bottles.

    → Practice social distancing by maintaining at least 6 feet between people when outside their home.

    → Properly wear a cloth face covering that covers their mouth and nose to protect others when in public areas.

    → Avoid touching their eyes, nose, or mouth with unwashed hands.

    Children may worry about themselves, their family, and friends getting sick with COVID-19. Tips for talking to children about COVID-19 can be found here: Talking With Children About Coronavirus Disease. Our school works closely with the New Hampshire (NH) Department of Health and Human Services (DHHS) to monitor the newest information about COVID-19.

    For more information on COVID-19 in NH, please visit NH Department of Health and Human Services  For the latest information from the CDC, please visit CDC Coronavirus information. Thank you for your support and partnership to keep our school healthy this year! 

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    School Health Services provide support to students to help them achieve and maintain their optimal level of health and wellness and be ready to learn. The school nurse is available to assist students and families with questions or concerns that relate to the child’s health. As a member of the school team, the school nurse works closely with teachers and others to ensure that the child’s educational goals are being met. 


    The primary goals of School Nurse Practice are to

    • Reduce students’ health-related absenteeism
    • Eliminate or minimize health problems that impair learning.
    • Reduce or prevent health problems through education.
    • Educate the community as to the health concerns of school-aged children.
    • Help students to achieve the highest degree of independent functioning.
    • Assist with referrals to community providers. 
    • Screening for hearing or vision difficulties that may impair student learning.



     Immunization requirements have changed.  You may receive a call if the school health record does not contain updated, required immunization information about your child.  You will be asked to provide proof of immunization as required by the State of NH for attendance in public schools.


    Cheshire Smiles provides services for students in pre-school through grade 3.  We will hopefully be offering dental services in grades 1 - 3 for those families that wish their students to participate. Fluoride increases the strength of tooth enamel , preventing cavities.

    - 100% Schools is no longer an active program:    It is an outreach program connecting uninsured children with health insurance, formerly known as NH Healthy Kids. This program was coordinated through the Health Office at schools in the district and is the primary reason we ask for insurance information. This is a service being conducted in conjunction with Cheshire Hospital and NH Department of Health and Human Services in an attempt to connect with all families that do not have health insurance coverage for their children and can direct them towards coverage.

    Please call Ruth Abbott at Cheshire Medical Center Family Resource Counseling and she will be able to assist you.

    Family Resource Counseling   <~~~click this link

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    A cumulative health record is maintained on each child, PK-12. This includes the required physical examination and documentation of state-mandated immunizations 
    (RSA 200:38). 



    Parents are required to provide the school with documentation of vaccination and physical examination.

    Parents can get the required blank forms from the school nurse or your child's medical provider can print the records for you.



     State of New Hampshire Mandated Health Requirements

    for Entering Kindergarten and First Grade 2021-2022


    Dear Parent or Guardian:

    Welcome to Troy School.  We would like to be able to assist you and your child with adjusting quickly and comfortably to a new school setting.  Of special importance to us is your child’s health and prevention of communicable diseases.


    New Hampshire State Law requires that all

    children must have a physical examination

    BEFORE entering school.

    ** All physical examinations must have been performed no earlier than September 1, 2020 **

    ** All physical examinations must have been performed no earlier than September 1, 2020 **

    Please submit documentation of the most recent physical examination and immunization record when registering your child, along with the date of the next scheduled physical examination. Any information made available to the school regarding allergies, physical condition, medication, etc. will assist staff and will become part of the student’s confidential health school record.  Click here to see the current state requirements for vaccination.

     2021-2022 New Hampshire School Immunization Requirements   <~~Click


    New Hampshire State Law, RSA 141-C: 20 requires all students in New Hampshire to be immunized against diphtheria, tetanus, pertussis, measles, mumps, rubella, polio, Hepatitis B, and Varicella (chickenpox) before enrolling in school. Children 3-5 years old, require Haemophilus Influenza Type B (Hib),


    • Children must have proof of all required immunizations, documentation of immunity, or valid exemptions, in order to be admitted or enrolled in any school in New Hampshire. Documentation of immunity by confirming laboratory test is acceptable for Measles, Mumps, Rubella, Varicella, and Hepatitis B.
    • A child may be “conditionally” enrolled when the parent or guardian provides: 1) Documentation of at least one dose for each required vaccine; AND 2) The appointment date for the next dose of required vaccine.
    • All immunizations must meet minimum age and interval requirements for each vaccine. A 4-day grace period is allowed; however, live attenuated vaccines (MMR, Varicella, or nasal influenza vaccine) that are not administered on the same day must be administered at least 28 days apart.
    • Medical and religious exemptions have specific requirements. Information is available at:
    • The 2021 Immunization Schedule from the CDC’s Advisory Committee on Immunization Practices can be found here:

    *For all minimum intervals and age requirements, a 4-day grace period is acceptable. 

    If your child does not have the required vaccines, s/he may be conditionally enrolled, if s/he received at least one dose of the required vaccines.  This requirement may be waived for medical reasons if evidence is presented from your physician that immunizations will be detrimental to the student’s health. For religious reasons, a written notarized statement must be presented to the school. 

    Please be aware that if your child is sick, it is very important to keep them home.  The student must be fever free (without fever reducing medicine), not vomiting, or on antibiotic medicine for at least 48 hours before returning to school. There may be additional requirements and guidelines regarding students with symptoms of COVID-19. Please contact me if you have any questions, I will be happy to help you.



    Amy Adams, BSN-RN

    Troy School Nurse

    links to supporting information:

    New Hampshire School Immunization Requirements 2020-2021

    2021-2022 State Mandate Health Requirements - registration, updated AEA, 07/27/2021



    A child may be admitted into school under conditional enrollment  if the documentation of immunization is incomplete,

    but an appointment date for the next dose must be provided to keep the child in school.  That date shall serve as the suspension date until immunizations are complete. ~~~


    The School Health Services program strives to keep healthy children healthy.  To that end, we must exclude students with contagious conditions such as, but not limited to:

     Chickenpox - The student must remain home for one week after first skin lesions appear or are crusted over.

     Strep Throat - The student must remain home for 24 hours after antibiotic treatment has started.

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    Students with other communicable diseases per NH State Law will remain at home. The school nurse will determine when it is safe for the child to return to school.

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     Screening Services:

    Student height and weight may be measured each school year. Vision and hearing is also available. The school nurse will make referrals to parents and/or physicians when appropriate.


    If you have any questions, please feel free to call the school nurse.


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    If your child was recently seen by a medical provider and received any vaccinations, please be sure to give the School Health Office a copy of this written information so that your child's school health records are up to date.




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