Annual Physical and Immunization Records

Annual Physical Form and Immunization Records

To be completed by the child's doctor's office
  • Physician Use Only

    The City of Dallas Health Department, which inspects our school periodically, requires that a Health Form be on file in the school for each student. Please bring this form with you to your child’s annual physical during the summer and have current immunization records printed for their school file.
  • You may also fax, email, or mail the child's Immunization Records to:

    Fax: 214-324-5671

    Email: office@whiterockmontessori.org

    Mail: 1601 Oates Drive, Dallas, Texas 75228

  • Electronic Signature