Puerto Rico school health requirements: what schools ask for and who provides it

These are the most common enrollment documents. For certificates outside school, such as the driver's license form, see medical certificates in Puerto Rico.

Many private schools, daycares and universities ask for a medical form at enrollment. In a School and work forms visit (US$35), Dr. Diana Nieves Castro, MD, a Puerto Rico-licensed general practice physician, evaluates your child by video and completes the form when the evaluation supports it. We see children of all ages and adults, in English or Spanish. More on school and work medical forms.

• Request your visit. On the booking page, choose School and work forms. Request a visit online 24/7 — we confirm your time by email or text.
• Have the form ready, along with vaccination records and any recent results.
• See the doctor by video. We send you a secure video link; it works on your phone, tablet or computer.

If the form asks for something that can only be done in person, such as a vision exam or vaccines, another provider handles that part. If the visit turns out to need a full doctor visit, the doctor explains why and, only with your consent, you pay the difference.

In Puerto Rico, if the patient is under 21, a parent with patria potestad (parental authority) or a legal guardian signs the consent, stays on the video for the whole visit and shows photo ID. This applies to university students under 21 too. To get a young child ready, see prepare your child for a video visit.

Puerto Rico's Law 25 of 1983 requires an immunization certificate to enroll in school or daycare. That certificate, the PVAC-3 or "hoja verde", is signed by the doctor or professional who gives the vaccines, and authorized providers generate it from the Puerto Rico Immunization Registry (PREIS). Vaccines are given in person.

Ask your child's vaccinating doctor, the clinic where they were vaccinated or a pharmacy that vaccinates. Families moving from the mainland should bring their child's vaccination records to that provider. For vaccine questions, the Department of Health's number is 787-765-2929, extensions 3337 and 3338.

The law allows a medical exemption from vaccines, but it requires a specific contraindication and its duration, and it is decided by a doctor who knows the child's full vaccination history. Talk to the doctor who keeps that history.

Law 63 of 2017 and its regulation require an oral exam certificate to enroll children in kindergarten and grades 2, 4, 6, 8 and 10, at public or private schools, daycares and social treatment centers. The exam must be recent (the regulation refers to the six months before the school year starts), and the certificate can only be signed by a Puerto Rico-licensed dentist.

At Puerto Rico public schools, the Department of Education's regulation lets a parent or guardian excuse an absence for illness with a signed written note, turned in within 5 days. The school may ask for a medical certification in some cases, for example when absences keep happening.

If your child is sick, the doctor evaluates them by video in an online doctor visit for kids and, if appropriate, gives you a doctor's note. A doctor's note after your visit is included at no extra charge.

The Department of Health's certificado de salud is for people in certain jobs, such as food handling. If an older teen needs one for a job, we give you the lab order for US$35; the TB skin test is placed and read in person. Read the health certificate guide.