Connecticut HAR-3 Health Assessment Record

Connecticut law (C.G.S. 10-204a and 10-206) requires complete immunizations and a health assessment before public school entry, with updates in grade 6 or 7 and grade 9 or 10. The HAR-3 is the State Department of Education's record of that assessment, kept in the cumulative school health record. It can also be used for the yearly assessments required for students on sports teams.

Who completes it

The parent completes Part 1, the health history. An MD, DO, APRN or PA completes and signs Part 2 and the immunization record; Part 3, the oral health assessment, is signed by a dentist, dental hygienist or trained MD, DO, APRN or PA.

Submitting and payment

How to submit it
Return the completed record to the parent, who gives it to the school nurse; the immunization record must be attached.

Good to know

  • Starred items are mandated screenings under state law, including height, weight, blood pressure, vision, hearing, gross dental, postural and speech at school entry.
  • Asthma or anaphylaxis answers trigger requests for an Asthma Action Plan or Emergency Allergy Plan; medication given in school needs a separate Medication Authorization Form.
  • The provider states whether the student may participate fully in school and in athletic activities, or lists restrictions or adaptations.
  • Medical exemptions require the signed state medical exemption form attached; religious exemptions must meet Public Act 21-6 criteria.

Get the official form

Download the current version from the source each time; forms change without notice.

Health Assessment Record

Registro de la Evaluación de Salud

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

When is the Connecticut HAR-3 required?

Before entering public school in Connecticut, again in grade 6 or 7, and in grade 9 or 10; the local board of education sets the exact grade. The form may also be used for the yearly health assessments required for students on sports teams.

Is the HAR-3 available in Spanish?

The State Department of Education's page posts the HAR-3 in English, current edition REV. 3/2024. Spanish versions from 2017 and 2018 circulate on district websites, but none is posted on the state page, so check with the school district before using an older translation.