Medical Requirements 2021-2022 School Year
STATE OF ILLINOIS HEALTH REQUIREMENTS FOR THE 2021-2022 SCHOOL YEAR
Students will NOT be able to attend school after Friday, September 17, 2021, until ALL required information is received.
REQUIREMENTS BY GRADE LEVEL
Preschool Students:
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Physical Exam- Parents please complete the Health History questions on the back and sign and date then verified by health care provider
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Lead Screening
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Dental Exam
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Complete immunization record signed and stamped by a doctor: (4) Dtap; (3) Polio; (4) Hib; (3) Hep B; (1) MMR; (1) Varicella; (4) Pneumococcal
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Proof of Income
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Certified Copy of Birth Certificate
Kindergarten Students:
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Physical Exam- Parents please complete the Health History questions on the back and sign and date then verified by health care provider; please make sure all areas are completed on physical form
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Lead Screening
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Complete immunization record signed and stamped by a doctor: (4 or more) Dtap; (4) Polio; (4) Hib; (3) Hep B; (2) MMR; (2) Varicella; (4) Pneumococcal
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Dental Exam on Illinois form
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Eye Exam on Illinois form
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Certified Copy of Birth Certificate
Second Grade Students:
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Dental Exam on Illinois form
Sixth Grade Students:
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Physical Exam- Parents please complete the Health History questions on the back and sign and date then verified by health care provider (Sports physical form NOT acceptable)
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If student is participating in sports, student’s healthcare provider may check interscholastic sports on the IL Certificate of Child Health Exam form
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Complete immunization record signed and stamped by a doctor, including (1) Tdap, (2) Varicella, (1) Meningitis
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Dental Exam on Illinois form
Ninth Grade Students:
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Physical Exam - Parents please complete the Health History questions on the back and sign and date then verified by health care provider (Sports physical NOT acceptable)
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If student is participating in sports, student’s healthcare provider may check interscholastic sports on the IL Certificate of Child Health Exam form
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Complete immunizations record signed and stamped by a doctor
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Dental Exam on Illinois form
Twelfth Grade Students:
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Proof of receiving (2) Meningitis: First dose received on or after the 11th birthday and second dose must be on or after 16th birthday. Only one dose is required if the first dose was received at 16 years of age or older.
Varicella Vaccine: Two doses of varicella for all students except for pre-kindergarten
All New Students entering an Illinois school for the first time are required to have a complete physical with an updated immunization record, dental exam, vision exam, and a certified copy of birth certificate.
