Florida Form DH 3040 is the state’s School-Entry Health Exam form. A parent fills out the medical history and consent on Part I, a licensed healthcare provider completes Part II during a physical examination performed within one year before enrollment, and the signed original goes to the school at registration.
When Your Child Needs a DH 3040
Florida law requires every child enrolling in kindergarten through twelfth grade for the first time to present a completed school-entry health examination performed within one year before enrollment.1Florida Senate. Florida Code 1003.22 – School-Entry Health Examinations; Immunization Against Communicable Diseases; Exemptions; Duties of Department of Health The requirement covers public and private schools alike. The DH 3040 is the recommended form for documenting the exam, but any equivalent form signed by a provider licensed to perform physical examinations in the United States is also acceptable.2Florida Department of Health. School Enrollment
The DH 3040 documents the physical exam only. Immunizations are recorded on a separate document, the DH 680, and both are required before a child may attend school.3Florida Department of Education. School Health Services Completing one does not satisfy the other.
Where to Get the Form
The Florida Department of Health hosts the blank form and its instructions in English and Spanish on its school enrollment page.2Florida Department of Health. School Enrollment Many pediatricians’ offices and county health departments also keep blank copies on hand, so you can often pick one up at the same visit where your child gets the exam.
Filling Out Part I: Medical History
Part I is yours. Fill in your child’s name, date of birth, sex, home address, school name, grade, and phone number, plus your own name as parent or guardian. Below that are eight yes-or-no questions about your child’s general health, illnesses or behavioral concerns, allergies, prescription medications, vision or hearing issues, prior hospitalizations, and past injuries. A final question asks whether you would like to discuss anything with the school nurse.
After answering, sign and date the parental consent line at the bottom of Part I. The form also has optional sections for a comprehensive vision exam (recommended for children ages three to five), a dental exam, and a hearing screening. These aren’t required by statute, but some districts encourage completing them and schools appreciate having them on file.
What the Provider Fills In on Part II
Part II is completed entirely by the healthcare provider during the physical exam. The provider records the date of the examination and screening results for height, weight, BMI percentile, blood pressure, hematocrit or hemoglobin, lead screening, and urinalysis. Vision and hearing are each tested and marked as passed, failed, or referred.
The physical exam section covers several body systems (dental, head and scalp, eyes, ears, nose, throat, chest, lungs, heart, abdomen, and postural assessment), each marked normal, abnormal, referred, or treated. The provider also indicates whether a tuberculosis risk assessment was done. Near the bottom, the provider notes any health conditions that could affect the child’s education (vision, hearing, speech, physical, social/behavioral, or cognitive) and specifies any conditions requiring emergency action at school.
Ask the provider about one checkbox parents often overlook: whether your child can participate fully in school activities including physical education, or whether restrictions or adaptations are needed. If your child has asthma, a heart condition, or another limitation, this is where the provider flags it for the school.
Who Can Sign the Form
The form must be signed by a health professional licensed to perform a general physical examination. That includes physicians (MDs and DOs), nurse practitioners, and physician assistants. The provider can be licensed in Florida or in whatever state the child lived in when the exam was performed.2Florida Department of Health. School Enrollment Chiropractors and dentists don’t qualify, because the exam has to cover the full range of systems listed on the form.
Submitting the Completed Form
Bring the completed DH 3040 to your child’s school during registration. Most schools want the original hard copy with the provider’s signature for the student’s permanent cumulative file. The school nurse or registrar reviews the form to confirm every section is filled in and that the exam date falls within one year of enrollment. If a section is blank or the exam is too old, the school will send it back, and your child may not be able to start classes until you provide a valid copy.
Schools have some flexibility on timing. A district school board may allow students up to 30 school days after enrollment to present the completed form.4Florida Senate. Florida Code 1003.22 – School-Entry Health Examinations; Immunization Against Communicable Diseases; Exemptions; Duties of Department of Health Not every district grants this grace period, so check with your school before assuming you can enroll first and submit later.
h2>Transferring From Another State
If your child had a physical exam in another state before moving to Florida, you don’t necessarily need a new one. A comparable form from another state is acceptable as long as a provider licensed to perform physical exams in the U.S. completed and signed it, and the exam took place within one year before enrollment in the Florida school.2Florida Department of Health. School Enrollment The out-of-state form should cover the same components as the DH 3040. If it’s missing key sections like physical exam findings or the provider signature, the school may ask for a new exam on the Florida form.
Exemptions and Temporary Waivers
Florida recognizes two situations in which a child can attend school without a completed DH 3040:
- Religious exemption. A parent may submit a written request stating objections to the health examination on religious grounds. No specific form is required, and a signed letter is sufficient. The religious exemption covers the health exam only, not immunizations, which have their own separate process under the same statute.5The Florida Legislature. Florida Code 1003.22 – School-Entry Health Examinations; Immunization Against Communicable Diseases; Exemptions; Duties of Department of Health
- 30-school-day temporary exemption. Children experiencing homelessness, children known to the Department of Children and Families, and students entering a juvenile justice program automatically receive a 30-school-day temporary exemption so they can attend class while records are obtained. The school nurse or authorized official follows up with these students until the documentation is in hand.4Florida Senate. Florida Code 1003.22 – School-Entry Health Examinations; Immunization Against Communicable Diseases; Exemptions; Duties of Department of Health
What the Exam Costs
If your child has health insurance, the school-entry physical is typically covered as a preventive well-child visit with no out-of-pocket cost. For uninsured families, self-pay prices at urgent care clinics in Florida start around $25 for a basic school physical. County health departments often offer the exam on a sliding fee scale based on income, and some run free back-to-school health fairs in the weeks before school starts. Call your local county health department to ask about reduced-cost options before paying full price at a private clinic.
Not to Be Confused With Texas Form 3040
If you arrived here searching by form number, note that Texas Form 3040 is unrelated. It is officially titled “Review Findings and Plan of Improvement” and is used by the Texas Health and Human Services Commission for facility and program quality reviews, not for school health exams or individual benefits applications.6Texas Health and Human Services. Form 3040, Review Findings and Plan of Improvement