Other States laws/regulations;

OLR Research Report

October 5, 2011




By: Nicole Dube, Associate Analyst

You asked if any state requires the completion of a “universal” child health form before a child can participate in school, sports, and child care activities so that parents and physicians do not have to complete multiple health forms.


We contacted several national organizations, including the American Academy of Pediatrics (AAP), Centers for Disease Control, National Conference of State Legislatures (NCSL), National Association of State Boards of Education, and the American School Health Association, and none were able to answer your question. Based on an internet search, we found that New Jersey and the District of Columbia (DC) use a universal child health form that is accepted by schools, athletic activities, and child care facilities. (A copy of each form is attached.) DC law requires the use of this form for its students attending pre-kindergarten through grade 12. New Jersey law does not require use of the form, which was developed by the state Department of Health and Senior Services.


DC law requires each student attending pre-kindergarten through grade 12 to annually complete a “Universal Health Certificate” that is signed by a physician or advanced practice registered nurse (DC ST 38-602 and DC ST 7-875.03). Among other things, the certificate must document completion of a physical exam within the last year and any age-appropriate immunizations. The certificate expires 365 days after the date of the physical exam listed on the form. To remain eligible for athletics, an updated certificate must be submitted to the school when a new physical exam occurs.

The certificate was developed by the DC Department of Health and follows the American Academy of Pediatrics guidelines for child and adolescent preventive health care. It is a confidential document that complies with the requirements of the 1996 Health Insurance Portability and Accountability Act (HIPAA) for health providers, and the 1974 Family Educational and Privacy Act (FERPA) for educational institutions. The certificate is used for entry into DC public, private, and parochial schools; Head Start programs; child care facilities; and athletic activities.


New Jersey's Department of Health and Senior Services created a “Universal Child Health Record” endorsed by the AAP and the New Jersey Academy of Family Physicians. According to the AAP, the form's use is not required by law but is authorized by department regulation. The form, which must be annually completed by students attending pre-kindergarten through grade 12, meets the requirements for school entry and participation in athletic activities. It must be completed by a physician, physician's assistant or advanced practice registered nurse.


District of Columbia Official Code, http://www.dccouncil.washington.dc.us/dcofficialcode , website last visited on October 3, 2011.

District of Columbia Universal Health Certificate, http://dchealth.dc.gov/doh/lib/doh/services/administration_offices/phsa/immunization/pdf/dc_universal_hc_final_feb_2409.pdf, website last visited on October 3, 2011.

New Jersey Universal Child Health Record, http://www.state.nj.us/health/forms/ch-14.pdf, website last visited on October 3, 2011.