Puerto Rico school health forms: what you need and who issues them

Puerto Rico school health forms at a glance: who issues each, and whether we do

This list covers the most common documents. For certificates outside school, such as the driver's license form, see medical certificates in Puerto Rico.

• PVAC-3 ("hoja verde") vaccination certificate: signed by the doctor or professional who gives the vaccines. We do not issue it.
• Oral exam certificate (certificado de examen oral): signed only by a Puerto Rico-licensed dentist. We do not issue it.
• Certificado de salud (health certificate): for workers, not students, and issued only by an authorized doctor at their authorized office. We do not issue it.
• School or daycare medical certificate or physical: needs an in-person exam. We do not issue it.
• Sports physical: needs an in-person exam. We do not issue it.
• Medical vaccine exemption: we do not issue it.
• Absence note: at public schools, a written note from a parent is usually enough. We can give a doctor's note, but only after a real visit.

PVAC-3 ("hoja verde"): the vaccination certificate

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).

Because we do not vaccinate and have no registry access, we do not issue the PVAC-3. Ask your child's regular 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.

Medical vaccine exemptions

The law allows a medical exemption from vaccines, but it requires a specific contraindication and its duration, and it should be decided by a doctor who knows the child's full history. We do not issue vaccine exemptions. Talk to your child's regular doctor.

Oral exam certificate

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. We do not issue it.

School or daycare medical certificate or physical

Many private schools and daycares ask for a "certificado médico" or a physical at enrollment. Each school or daycare sets its own form, and it requires a doctor to examine the child in person, usually the regular doctor at a well-child check. We do not do physicals or well-child checks by video.

Sports physicals

The American Academy of Pediatrics recommends doing the sports physical at your child's next well-child visit with their regular doctor, and advises against group physicals and urgent-care physicals. It needs an in-person exam, so we do not do it by telehealth.

The certificado de salud is not for students

The Department of Health's certificado de salud is for people who work in certain jobs, such as food handling. It includes a tuberculosis test and a syphilis test, and only a Department-authorized doctor can issue it, at the authorized location. We do not issue it. Read our health certificate guide.

Notes for school absences

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. That is why a doctor's note is often not needed. The school may ask for a medical certification in some cases, for example when absences keep happening.

If your child is sick now, the doctor can assess them by video and, if appropriate, give you a doctor's note for that illness. We do not issue notes without a real visit or for days we did not assess your child. The note has no extra charge; it is part of the US$79 visit. See doctor's notes and the online doctor visit for kids.

Frequently asked questions

Where do I get my child's PVAC-3 ("hoja verde")?

From your child's regular doctor, the clinic where they were vaccinated or a pharmacy that vaccinates, because it is signed by whoever gives the vaccines. We do not vaccinate, so we do not issue it.

Can my child's school physical be done by telehealth?

No. A school, daycare or sports physical requires a doctor to examine your child in person. We do not do physicals or well-child checks by video.

Which grades need the oral exam certificate?

Kindergarten and grades 2, 4, 6, 8 and 10, under Law 63 of 2017 and its regulation. Only a Puerto Rico-licensed dentist can sign it.

Do I need a doctor's note if my child missed school because they were sick?

At public schools, a written note from a parent turned in within 5 days is usually enough. If the school asks for a doctor's note, we can only provide one after assessing your child in a real visit.

Related pages

• Puerto Rico health certificate
• Doctor's note
• Online doctor for kids
• Medical certificates in Puerto Rico
• What we don't do
• Prepare your child for a video visit