School Alert
School Alert
Medical

OTC Medication Administration Authorization

Prescription Medication Administration Authorization

DHS School Physical Form

Illinois Dental Exam Form

Illinois Vision Exam Form

Certificate of Religious Exemption

Concussion Staging Form

Nut Free Guidelines for Snacks and Treats (Early Ed-5th Grade)

  • Treats brought to school intended to be shared with classmates MUST be pre-packaged and nut-free and brought to the office to be approved by the school nurse.
  • Only store-bought items will be permitted to be shared with classmates. Homemade items will not be allowed for class parties or special celebrations.
  • Treats to be shared with classmates must include ingredient labels.
  • Please refer to the list of suggested nut free snacks and treats presented at www.snacksafely.com.

State of Illinois Student Health Record Requirements

(105 ILCS 5/27-8.1 and Illinois Administrative Code Part 665)

All required records must be submitted on State of Illinois standard forms.  These forms are available from your health care provider and on our website (see links above).  Students may be excluded from school after October 15 if required forms are not on file with the school office.

Students entering EARLY ED must show proof of:

  • Complete immunization record including:
    • DPT or DTaP- 4 doses          
    • Hep B- 3 doses
    • Hib
    • MMR
    • Pneumococcal Conjugate
    • Polio- 3 doses
    • Varicella
  • Physical exam completed within 12 months prior to the first day of school 

Parents, please complete and sign the Health History on the back of the physical exam form before submitting to the school office.

If student is attending Early Ed for a THIRD CONSECUTIVE YEAR, please contact the school office for requirements.

Students entering KINDERGARTEN or students in ANY GRADE who are enrolling in an Illinois school for the FIRST time must show proof of:

  • Complete immunization record including:
    • DPT or DTaP- 5 doses        
    • MMR-2 doses
    • Polio- 4 doses
    • Varicella- 2 doses
  • Physical exam completed within 12 months prior to the first day of school

Parents, please complete and sign the Health History on the back of the physical exam form before submitting to the school office.

  • Dental exam completed within 18 months prior to the May 15 deadline
  • Eye exam completed within 12 months prior to the first day of school

Students entering 2ND GRADE must show proof of:

  • Dental exam completed within 18 months prior to the May 15 deadline

Students entering 6TH GRADE must show proof of:

  • Complete Immunization Record including:                      
    • Meningococcal Conjugate (MCV4) -1 dose
    • Hepatitis B- 3 doses
    • Tdap booster
    • Varicella- 2 doses
  • Physical exam completed within 12 months prior to the first day of school

Parents, please complete and sign the Health History on the back of the physical exam form before submitting to the school office.

  • Dental exam completed within 18 months prior to the May 15 deadline

Students entering 7th-12th GRADE who have not already received a Tdap booster must show proof of:

  • Tdap dose regardless of the interval since the last DTaP

Students entering 9TH GRADE must show proof of:

  • Complete Immunization Record including:             
    • Tdap booster
    • Varicella- 2 doses
  • Physical exam completed within 12 months prior to the first day of school

Parents, please complete and sign the Health History on the back of the physical exam form before submitting to the school office.

  • Dental exam completed within 18 months prior to the May 15 deadline

Students entering 12th GRADE must show proof of:

  • Meningococcal Conjugate (MCV4) – 2 doses: If the first dose of MCV4 was administered ≥ 16 years of age, only 1 dose of MCV4 is required at 12th grade entry.

 

 

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