Sample Letter for Public and Private Schools
☐ MMR (measles, mumps, rubella) ☐ PCV/PPSV (pneumococcal) ☐ IPV/OPV (polio) ☐ DTaP (diphtheria, tetanus, pertussis) ☐ Tdap (tetanus, diphtheria, pertussis) ☐ Hepatitis B ☐ Hib (Haemophilus influenzae type b) ☐ Varicella (chickenpox) Documentation must be turned into school/child care by [INSERT DATE – 30 DAYS AFTER VACCINE DUE ... ................
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