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7th Grade Immunization

Grade 7 Physical Exam & Immunization Form Information

Important information regarding health forms required for all incoming 7th grade students. 

Per Florida Statute 1003.22 and Palm Beach County School Board Policy 5.06 all incoming 7th grade students are required to provide a valid health examination form (DH3040) and an immunization form (DH680) for school attendance.  These are the only acceptable forms.

For your convenience, you can email bonnie.benjamin@palmbeachschools.org or fax the DH680 immunization form indicating all up-to-date vaccines, including the Tdap and both sides(parent side completed, signed and dated & physician side) of the DH3040 health examination form.  The DH3040 health form must be dated on or after August 10, 2020 to be in compliance. 

 If your child has a medical or religious exemption, we must have that on file as well.

Should you have any questions, please do not hesitate to contact me directly.

Mrs. Bonnie Benjamin
Student Services
Don Estridge High Tech Middle School
561-989-7858 (phone)
561-989-7810 (fax)



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Don Estridge High Tech Middle
1798 NW Spanish River Blvd
Boca Raton, FL 33431
(561) 989-7800
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