School Physical Examination Form
All children in the State of Illinois are required by law to have a health examination and provide proof of having received the required immunizations. Students enrolling in the following grades must provide a completed Certificate of Child Health Examination and Immunization record at the start of the school year:
- Pre-School/Early Childhood*
- 6th Grade
- Students transferring from out of state
*For Pre-School and Kindergarten students: a lead screening is a required part of the health examination.
Immunization requirements for the State of Illinois can be found here
The school physical examination must be dated within one year prior to the first day of school. Parents must complete and sign the Health History section on the examination form and your child's physician must complete all of the physical examination requirements.
It is recommended that you keep a copy of your child's examination at home for your records.
Families who object to their child having health examinations or immunizations are required to complete the Illinois Certificate of Religious Exemption which must be signed by the child's parent or legal guardian AND the child's health care provider responsible for performing the child's health examination.
Eye Examination Form
Illinois law requires that proof of an eye examination by an optometrist or a physician who provides complete eye examinations be submitted to the school nurse no later than October 15 of the year the child is first enrolled in kindergarten or is enrolled for the first time in a State of Illinois school. The examination must be completed within one year prior to October 15th of the year the child enters an Illinois school. If you are unable to provide proof of an eye examination, please return the Eye Exam Waiver Form to the school nurse.
All children enrolling in kindergarten in a public, private, or parochial school and any student enrolling for the first time in a public, private, or parochial school shall have an eye examination. Each of these children shall present proof of having been examined by a physician who performs eye examinations or an optometrist within the previous year (within one year prior to the date of entering school), in accordance with Section 27-8.1(1.10) of the School Code and this Part before October 15 of the school year. (Section 27-8.1(1.10) of the School Code)
Dental Examination Form
All children in the State of Illinois in kindergarten, 2nd, and 6th grade are required to to have an oral health examination. Each child is required to submit a proof of dental examination by a dentist prior to May 15 of the school year and the examination must have been completed within 18 months prior to the May 15th deadline. If you are unable to provide proof of a dental examination, please return the Dental Exam Waiver Form to the school nurse.