The Texas Form M-51 spinal screening report is the one-page record a certified screener fills out after examining a student for scoliosis, kyphosis, or other abnormal curvature of the spine, and it lives in the student’s school health file. The blank form and line-by-line instructions sit in Appendix A of the DSHS Spinal Screening Manual, which is posted as a PDF on the Texas Department of State Health Services website.1Texas Department of State Health Services. School Spinal Screening Guidelines A campus health office can also print copies on request.
Who Is Allowed to Sign the Form
Only two kinds of people can complete and sign an M-51. The first is a licensed professional whose scope already covers physical assessment: physicians, chiropractors, physical therapists, and registered nurses with physical-assessment coursework. They need no additional DSHS paperwork.2Texas Department of State Health Services. Screening Information and Procedure Everyone else must hold a current DSHS spinal screening certificate earned through an approved course.3Legal Information Institute. 25 Texas Administrative Code 37.143 – Spinal Screening Procedures Your signature on the form confirms you held one of those two credentials on the day of the screening.
If a student is exempt through a religious affidavit, a parent-signed private-screening affidavit, or an active-care letter from a treating provider, no M-51 is filled out for that student. The exemption document itself goes in the health file in place of the form.3Legal Information Institute. 25 Texas Administrative Code 37.143 – Spinal Screening Procedures
Filling In the Identifying Information
Start at the top of the form with the fields that identify the student and the exam:
- Student name and date of birth, written exactly as they appear in school enrollment records.
- Campus name and any assigned student ID number.
- Date of screening, written as the exact date the exam took place. This date is what verifies the screening fell within the required age or grade window for that student.1Texas Department of State Health Services. School Spinal Screening Guidelines
Those windows are age 10 and age 12 (or fifth- and seventh-grade fall semesters) for girls, and age 13 or 14 (or eighth-grade fall semester) for boys.2Texas Department of State Health Services. Screening Information and Procedure A date outside the window is a flag an inspector will catch, so double-check before you sign.
Recording the Clinical Findings
The clinical findings section is where the results of the six-position exam land. Many screeners use the School Spinal Screening Worksheet during the exam itself, then transfer the observations to the M-51 afterward; the worksheet is in the same manual appendix.1Texas Department of State Health Services. School Spinal Screening Guidelines
Record specific visual observations rather than general impressions. The findings that belong on the form come from the standing views and the Adams forward bend:
- Uneven shoulder height, or a difference in the gap between arm and torso on each side.
- Uneven waist creases or hips that are not level.
- A shoulder blade sitting higher or more prominently than the other.
- A visible hump along one side of the rib cage or lower back during the forward bend.
- Exaggerated rounding of the upper back (kyphosis) or an exaggerated arch in the lower back, seen from the side.
- Head not centered over the buttock crease when viewed from behind.
If you used a scoliometer, write the degree of trunk rotation as a number. Place the instrument gently across the back at the point of greatest asymmetry with the zero mark over the spine’s ridge, and do not press down; pressure distorts the reading.1Texas Department of State Health Services. School Spinal Screening Guidelines
Note on the form whether the student is already under care for a known spinal condition. That detail changes the follow-up path and keeps the record consistent with any treating-provider letter in the file.
What the Scoliometer Number Means for Follow-Up
The trunk-rotation reading drives the referral decision recorded on the form:
- 5 or 6 degrees: rescreen the student in six months to a year to watch for progression.
- 7 degrees or more: refer the student for evaluation by a physician.1Texas Department of State Health Services. School Spinal Screening Guidelines
When a referral is warranted, the school sends home the Spinal Screening Program Parent Notification and Referral form, also in the manual’s appendix. The M-51 itself still stays in the health file. If the screening shows no concerns, the signed form goes in the file and no further action is needed from the family.
Signing and Dating
The certified screener signs and dates the completed form. The signature is what gives the record its legal weight: it attests that the person conducting the exam held a current DSHS certificate or a qualifying professional license on the date shown. An unsigned M-51 is not a complete record.
Where the Form Goes After You Sign It
Each completed M-51 goes into the student’s school health file and must be kept on site for at least two years. When a student transfers campuses, the screening record can go with them, and parental consent is not required for that transfer. DSHS may send a representative to inspect a school’s spinal screening records at any time, so forms should be stored where they can be pulled quickly.4Legal Information Institute. 25 Texas Administrative Code 37.145 – Recordkeeping and Reporting
How M-51 Feeds the Annual Report
The individual forms are the raw material for the aggregate report every Texas school must submit to DSHS by June 30 each year. The reporting window opens January 15, and vision, hearing, and spinal results all go in through the same online submission, so screening totals should be compiled before you start the entry.5Texas Department of State Health Services. Vision, Hearing and Spinal Screening Annual Reports
Pulling totals from the signed M-51s on file, you will report across 14 categories: students screened per grade, students already under prior treatment, total abnormal findings, how many of those findings resulted in a physician diagnosis of scoliosis, kyphosis, or another curvature, and how many students received a treatment plan involving observation, bracing, or surgery.4Legal Information Institute. 25 Texas Administrative Code 37.145 – Recordkeeping and Reporting No individual names go into the report. A school that conducted no screenings during the year still has to submit the report, filing zeros rather than skipping it.
Companion Forms You May Need Alongside M-51
Four other documents from Appendix A of the Spinal Screening Manual usually travel with the M-51 through the screening cycle:1Texas Department of State Health Services. School Spinal Screening Guidelines
- Sample Pre-Screening Letter to Parents, sent home before the screening date so families have time to submit an exemption affidavit if they want one.
- School Spinal Screening Worksheet, used by the screener during the exam before results are transferred onto the official M-51.
- Spinal Screening Program Parent Notification and Referral, sent home when the screening indicates a child should be seen by a physician.
- Affidavit of Religious Exemption, the template a parent signs to opt the child out on religious grounds.
Schools may create their own internal recording forms, but the official M-51 is the document that satisfies the state recordkeeping requirement. Anything else is a working paper.