Health Office Forms

Pinecrest St. Rose families,

Pinecrest Academy St Rose wants to provide a healthy school environment for all students.  In order for us to better serve all students we need to update your child's  health record yearly – this includes medical diagnoses, surgeries, current  medications (given at home as well as school), allergies (seasonal, drug, food, life threatening), and any other pertinent health information about your child. 

  • Please fill out the Student Health Information Form for School Year 2018-19 and return to our office.

 RE:      Tdap and MCV4 Vaccine Requirements

This is confidential information and will be provided to appropriate school staff members as necessary to facilitate a safe, supportive environment. 


According to Nevada State law students must be vaccinated against Bordetella Pertussis (whooping cough) and Neisseria meningitidis (meningitis) PRIOR to entering the 7th grade.  Your child will need to have these vaccinations before the first day of school or your child will not be allowed to attend school until the mandatory immunization requirements are completed.

Please contact the school Health Office should you have any questions or concerns. If your child has already had these vaccines, please provide an updated immunization record to the Health Office.

Additional information regarding the Tdap and MCV4 vaccine requirements for incoming 7th grade students, locations of the Southern Nevada Health District’s clinic sites and fees can be found by visiting their website at www.southernnevadahealthdistrict.org .

Please feel free to call our Health Office at (702) 750-9150 ext. 2010 with any questions or concerns you may have.

Thank you in advance for your cooperation.


Mae Baltazar

Pinecrest St. Rose FASA