Hawaii is one of a handful of states that requires a physical exam, immunization records, and tuberculosis clearance before a child can attend any public or private school. All three must be completed within one year before the first day of attendance — and again before seventh grade. Here is every form, where to get it, and the timeline.
Last verified: September 1, 2026
Under Hawaii Administrative Rules §11-157, every child entering a Hawaii school for the first time — and every child entering seventh grade — must have a physical examination performed by a U.S.-licensed physician, APRN, or PA within one year before the first date of attendance.
The exam must be documented on the Hawaii DOH Student Health Record form (Form 14), which the school keeps on file. Most Hawaii pediatricians stock this form, or you can download it from the Hawaii DOH Disease Outbreak Control Division.
Hawaii requires documented immunizations for all students entering childcare, kindergarten, and 7th grade — and for all students entering a Hawaii school for the first time, regardless of grade. The required vaccines depend on the child's age and grade level.
Kindergarten through Grade 12:
Additional requirements for 7th grade entry:
Hawaii requires TB clearance before a child can attend school — a requirement most mainland states do not have. TB clearance must be obtained within one year before the first date of attendance and again before seventh grade.
TB clearance options include a TB skin test (TST/Mantoux) or an IGRA blood test. If the test is positive, a chest X-ray and physician evaluation are required before clearance can be issued. Children arriving from countries with high TB prevalence may need additional evaluation.
Hawaii requires the physical exam, immunization review, and TB clearance — all three at the same visit when possible. The TB skin test requires a return visit 48–72 hours later to read the result, so plan ahead.
Ask your pediatrician to check HiSIS (Hawaii State Immunization System) for completeness. Address any missing doses — especially HPV for 7th graders (a requirement that catches families transferring from other states off guard).
Hawaii law requires all three documents — physical exam (Form 14), immunization records, and TB clearance — on file before the child begins classes. Students without complete documentation may be excluded until records are provided.
Hawaii families juggling the physical exam, immunization records, TB clearance, and HPV requirements across multiple providers know how quickly paperwork scatters — especially if you're arriving from the mainland. Family Stork brings it all together.
Give any Hawaii clinic your child's private @families.familystork.com address. They send vaccine records and visit summaries — the health timeline builds itself. When the school asks for Form 14 and TB clearance, the complete record is already organized.
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Hawaii recognizes medical exemptions from school immunization requirements under HAR §11-157. A medical exemption requires a licensed physician's written statement that immunization would be harmful to the child. Hawaii also recognizes religious exemptions, which require a signed statement from the parent or guardian. Hawaii does not offer a personal belief or philosophical exemption.
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Give any Hawaii clinic your child's private @familystork address. They send records; the timeline builds itself. No portal logins, no uploads, nothing for the clinic to learn.
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