District Health Expectations and Forms

Last Updated: 7/27/2023 2:57 PM

 

State of Illinois Health Requirements for 2023-24 School Year

 

 

Health Forms and Grade Level which they are needed

 

Early Childhood Physical Form (Both Pages)

Kindergarten		 Physical Form (Both Pages)
Eye Examination Form
Dental Examination Form
2nd Grade Dental Examination Form
6th Grade Physical Form (Both Pages)
Dental Examination Form
9th Grade Physical Form (Both Pages) 
Dental Examination Form
12th Grade Proof of 1 Meningitis Shot after 16th birthday
SPORTS

Pre-Participation Examination Form 
or Physical Form ( Both Pages) 

New to Our District 		 All Forms Needed
Physical Form (both pages), Eye Examination Form,
and Dental Examination Form 
HIPAA-Compliant Authorization Release of Health Information Form


 

Medication that is Needed at School
Documentation from the Doctor is Required 
Administer Medication Form

 

Inhaler needed at School 
Asthma Action Plan Form (Both Pages)

 

Epi Pen Plan /  Allergies 
Allergy Emergency Action Plan and Treatment Authorization Form (Both Pages)

 

Food Substitution Form (Required)
Physician Statement for Food Substitution

 

Religious Exemption Form
Physician Statement for Required Immunizations

HEALTH INFORMATION
for Families 

 

COVID-19 Guidelines and Safety Procedures

 

Flu Guide for Parents

 

Any Questions
Please Do Not Hesitate to Call Your Student's School Nurse!