Dear Parent or Guardian:
If your child is entering any of the following grades, please note the medical forms needed. The physical and immunization record must be brought in at registration or by the first day of school or your child will not be allowed to start school.
K or new students to the district:
Polio: 4 doses with the last dose after the 4th birthday
Diphtheria, Tetanus, Pertussis: 4 or more doses with the last dose after the 4th birthday
Measles, Mumps, Rubella: 2 doses with the first at 12 months of age and the second at least one month later
Hepatitis B: 3 doses
Varicella (Chickenpox): 2 doses or proof of having disease
Proof of lead screening or blood test
Birth certificate: copy from the county courthouse in the county which your child was born, this is not the certificate from the hospital
2nd grade - Dental Exam
6th grade -Physical, Tdap Vaccination, Varicella vaccination: (2 doses at least 28 days apart), Dental Exam
9th grade - Physical, Tdap Vaccination (regardless of date of last tetanus), dental exam
12th grade -2 doses of Meningococcal vaccination, if first dose administered after the age of 16, then one dose is required for school entry
I appreciate your cooperation in keeping our school safe and healthy. If I may be of any assistance or if you have any questions, feel free to call me at 676-1521, ext. 333.
Alecia Roosevelt, School Nurse
PLEASE NOTE: No medication (even over the counter medication like Tylenol, Tums, Ibuprofen, etc.) will be given to a student without a signed "Permit to Give Medication" form on file.
Dental Safari is coming this spring. Download the forms and brochures here!
Dental Safari Brochure
Dental Safari Consent
State of Illinois Eye Exam Report
State of Illinois Dental Exam Form
State of Illinois Certificate of Child Health Examination
Summer Food Program Information (Hunger Outreach) from ISBE