Dear Parent or Guardian:
I am contacting you regarding an important health matter concerning your child,
______________________________________________________. The North
Carolina General Statutes (G.S. 130-A-152 (a)) require immunizations for every child
present in this state. Every parent, guardian or person in loco parentis is responsible
for ensuring that their child(ren) receive required immunizations.
Your child is not in compliance with this law. Your child needs the following vaccine(s):
If your child has a medical or religious exemption to this vaccine, you are required
to provide documentation.
You will be given 30 days to comply with the immunization requirements. If this
situation is not resolved in 30 days your child will be suspended from school
until the immunization requirement is met. Your child must receive the necessary
immunization(s) and provide documentation to the school by _________________
or he/she will be suspended from school until this requirement is met.
Please contact your primary care provider or local health department to schedule an
appointment for the appropriate immunization(s).
If there are questions or additional information is needed please contact the school at:
Thank you for your understanding and for your prompt cooperation in
attending to this important matter.