Health Forms & Guidelines

Entrance into Preschool or PreK

Please provide the following by October 15th:

  • Certificate of Child Health Examination: The completed physical examination must:
    1. include a Health History section to be completed by the parent/guardian, found at the top of the second page.
    2. include all the required immunizations
    3. include a completed lead risk assessment section. All students between 6 months and 6 years of age must have the lead risk assessment documented and blood test completed if the assessment indicates this. For those living in zip code 60456, a lead blood test is required and the results must be documented.

Entrance into Kindergarten

According to the regulations of the State of Illinois, by October 15th of your child’s kindergarten grade year all Illinois students are required to provide a:

  • Certificate of Child Health Examination: The completed physical examination must:
    1. include a completed diabetic risk assessment section
    2. include a Health History section to be completed by the parent/guardian, found at the top of the second page.
    3. include all the required immunizations, including the newly required second dose of the
      varicella/chickenpox vaccine.
    4. include a completed lead risk assessment section. All students between 6 months and 6 years of age must have the lead risk assessment documented and blood test completed if the assessment indicates this. For those living in zip code 60456, a lead blood test is required and the results must be documented.
    5. have been completed within one calendar year prior to the first day of kindergarten.
  • Proof of School Dental Examination
  • Proof of Eye Examination

A completed physical examination must be submitted to school by October 15th of the kindergarten school year or your child will be excluded from school until this requirement is met.

 

Entrance into Second Grade

  • Proof of School Dental Examination

Entrance into Sixth Grade

According to the regulations of the State of Illinois, by October 15th of their sixth grade year all
Illinois students are required to provide a:

  • Certificate of Child Health Examination: The completed physical examination must:
    1. include a completed diabetic risk assessment section,
    2. include a Health History section to be completed by the parent/guardian, found at the top of the second page,
    3. include all the required immunizations, including the newly required meningococcal vaccine,
    4. 2 doses of varicella/chickenpox vaccine, 3 doses of hepatitis B vaccine and a Tdap vaccine within the past year.
    5. have been completed within one calendar year prior to the first day of sixth grade.
  • Proof of School Dental Examination

A completed physical examination must be submitted to school by October 15th of the sixth grade school year. If the completed physical examination form is not received by October 15th, your child will be excluded from school until this requirement is met.

Transfer Students

  • ALL transfers must have an Illinois Certificate of Child Health Examination Form
  • ALL transfers from out of state must have an Eye Examination
  • If the student is entering Kindergarten, Second or Sixth grade, they must comply with the above requirements

Medication Form

  • District 123’s Board of Education has adopted a medication policy which requires a medication authorization form to be completed by the physician and parent. Please contact the school nurse regarding this form.
  • Only those medications necessary to the health and well-being of a student and which must be given during school hours may be administered to a student. ALL medications given to students must be prescribed by a licensed prescriber on an individual basis.
  • A written order for prescription and nonprescription medications must be completed in its entirety and filed with the school nurse before any medications will be administered. All medications are to be kept in the school nurse’s office.

 

For more information about the District’s policy regarding administering medications to students, please review the Board policy.

ALL parents must complete the emergency information sheet in the registration packet and indicate whether or not there is a medical issue, medication, glasses, hearing aids, etc.