Hawaii Form 14 is the Student Health Record that every child must have on file before attending a public or private school in the state. A parent completes the identifying information at the top, and a licensed healthcare provider fills in the physical exam findings, immunization history, and tuberculosis clearance before signing the form. You then bring the completed original to the school registrar during enrollment. The current version is dated February 2022 and is available as a PDF from the Hawaii Department of Education website.1Hawaiʻi State Department of Education. Student Health & Immunization Requirements
What to Bring to the Provider Appointment
Most of Form 14 gets filled out at your child’s medical appointment, so the visit is where the form succeeds or fails. Gather these before you go:
- Any existing vaccination cards or immunization records from previous providers, especially if your child is transferring from out of state or from a private school.
- Prior TB clearance paperwork, so the provider can note it on the form rather than repeating the process.
- The school name, grade level, and expected first day of attendance. The form asks for entry dates at each school level: Pre-K, Elementary, Intermediate/Middle, and High.2Hawaii State Department of Education. Hawaii Department of Education Form 14 – Student Health Record
Missing a single vaccine dose is one of the most common reasons a Form 14 gets sent back, so bring every record you have even if you think it duplicates something the provider already has.
The Physical Examination
A comprehensive physical exam must be completed within one year before the student’s first day at a preschool or school in Hawaii, and again before the first day of seventh grade.1Hawaiʻi State Department of Education. Student Health & Immunization Requirements On the form, the provider checks each body system as Normal, Abnormal, or Receiving Care. The categories include eyes, ears, nose, throat, teeth, heart, lungs, abdomen, nervous system, skin, scoliosis, extremities, and nutrition.2Hawaii State Department of Education. Hawaii Department of Education Form 14 – Student Health Record
Form 14 also has an integrated dental section where the provider records the date of a dental check-up. This section applies “if recommended/required based on screening/EPSDT requirements,” so your provider will determine whether it needs to be completed for your child.
Required Immunizations
Students in kindergarten through twelfth grade need documented vaccinations against the following diseases:3Hawaii State Department of Health. Hawaii Administrative Rules Title 11 Chapter 157 – Examination and Immunization
- Diphtheria, tetanus, and pertussis (DTaP)
- Hepatitis A
- Hepatitis B
- Measles, mumps, and rubella (MMR)
- Polio (IPV)
- Varicella (chickenpox)
Students entering seventh grade have three additional requirements on top of everything above:4Hawaii State Department of Health. School Health Requirements
- Human papillomavirus (HPV)
- Meningococcal conjugate (MCV)
- Tetanus-diphtheria-pertussis booster (Tdap)
Students entering any Hawaii school for the first time in seventh grade or higher must show evidence of all required immunizations before attending. The provider records the date and type of each vaccination directly on Form 14.
Tuberculosis Clearance
All students over twelve months old enrolling for the first time in a childcare facility, school, or college in Hawaii need TB clearance, but not every child will need an actual TB test. The healthcare provider first conducts a risk assessment. Students who have spent time in countries where TB is more common, were exposed to someone with active TB, or have a weakened immune system will need to be tested. Children with a household member from a high-prevalence country also need testing.5Hawaii State Department of Health. Frequently Asked Questions about TB Testing for Students
When testing is required, the standard method is a tuberculin skin test. A blood test called an IGRA can substitute for children five and older. If a student shows TB symptoms or tests positive, a chest x-ray is needed to rule out active disease before the student can attend school. The provider must document the date and results of the TB clearance on Form 14, and this is a frequent point of omission, so confirm the section is signed and dated before you leave the office.
The Parent Section at the Top
The top portion of the form asks for the student’s full legal name, date of birth, and home address, plus entry dates at each school level.2Hawaii State Department of Education. Hawaii Department of Education Form 14 – Student Health Record Match the name and date of birth to the birth certificate and enrollment form exactly. Even small discrepancies, like a middle name that appears on one document but not the other, can slow down registration.
Before you leave the provider’s office, review the whole form yourself. Confirm every immunization date is filled in, the TB clearance section is signed, and the physical exam section has entries for all body systems. Catching a blank field now saves a second trip.
Submitting Form 14 to the School
Bring the completed Form 14 to the registrar at your child’s school during enrollment. School offices typically require the original paper form. The registrar reviews the dates and entries against state health requirements. If the form is complete, you usually get confirmation on the spot. If anything is missing or inconsistent, the school will send a notice explaining what needs to be corrected and a deadline to fix it.
Timing matters. Schools enter health data into the electronic student information system before instruction begins, and a student without a cleared Form 14 risks being excluded from class.
Provisional Attendance If Vaccines Aren’t Finished
If your child has started the required vaccine series but hasn’t finished it, the school can grant provisional attendance. Under Hawaii Administrative Rules §11-157-6.2, the provisional period lasts up to three calendar months from the date of provisional attendance.6Legal Information Institute. Hawaii Code R 11-157-6.2 – Provisional Attendance
If the remaining doses can’t be completed within three months because the vaccine schedule requires minimum intervals between doses, the school can extend provisional attendance. You will need to provide evidence that appointments have been scheduled to complete the series. Once the final dose is administered, bring the updated Form 14 back to the school to move your child out of provisional status.
Exemptions From Immunization Requirements
Hawaii recognizes two grounds for exempting a child from required immunizations under HRS §302A-1156:7Justia Law. Hawaii Revised Statutes Title 18 Chapter 302A Section 302A-1156 – Exemptions
- A medical exemption, when a licensed physician, physician assistant, or advanced practice registered nurse certifies that the child’s physical condition is such that immunizations would endanger their life or health.
- A religious exemption, when a parent, guardian, or other person responsible for the child objects in writing on the grounds that immunization conflicts with their bona fide religious beliefs and practices.
To use either exemption, you present satisfactory evidence to the appropriate school official. Once accepted, the school will not require a certificate or other proof of immunization for entry. A bill introduced in the 2026 legislative session (HB 1118) proposes removing the religious exemption going forward, though as of this writing it has not been enacted. If you are relying on a religious exemption, check with your school for the current rules before the start of the school year.
The Seventh-Grade Update
The transition to seventh grade triggers a fresh round of Form 14 entries. Your child needs a new physical examination completed within one year before their first day at the middle or intermediate school, plus the three additional immunizations: HPV, MCV, and Tdap.4Hawaii State Department of Health. School Health Requirements Many providers use this appointment to review the entire immunization record and catch any doses that were missed or underdocumented earlier.
Schools typically send notices about seventh-grade health requirements during the spring or summer before the school year begins. Don’t wait for the notice to schedule the appointment. Pediatrician offices get heavily booked in the months before school starts, and an incomplete Form 14 on the first day means your child can be excluded until the paperwork clears.