School Assessment Reports

Schools are required to submit EPI 12A or EPI 12B reports to the Hawaii Department of Health by October 10 and January 10 of every school year to report students who have not complied with the State health and immunization requirements upon school entry, including students who have religious or medical exemptions. The EPI 12A report should be submitted by child care centers, preschools, and head start programs and the EPI 12B by schools with students in kindergarten through 12th grade.

School Immunization Assessment Report Forms (EPI 12 reports)

EPI 12A – Child care centers, preschools and head start programs (PDF)  (XLS*)
EPI 12A – Instructions (PDF)
EPI 12B – Grades kindergarten–12th (PDF)  (XLS*)
EPI 12B – Instructions (PDF)

*Fillable forms should be faxed or mailed. Electronic submissions will not be accepted.

School List (School Year 2019-2020)

Training Videos


Immunization Exemptions – medical and religious exemption data submitted by each school for students in kindergarten through grade 12


Last reviewed April 2019