Physical Examination and Immunization Requirements for Students Entering Kindergarten

According to the Illinois School Code

1. HEALTH EXAMINATION – Conducted within one year (Must be dated within one year prior to the first day of school)

• Physical Exam ­ signed and dated by doctor Immunizations ­ signed and dated by doctor

• Medical History – completed and signed by parent Physical Education Participation – checked off by doctor Mandatory Diabetes Risk Assessment

• Mandatory Lead Assessment

2. REQUIRED IMMUNIZATIONS:

• DTP/DTAP-­ 4 or more doses- last booster after 4birthday

• Polio ­- 4 or more doses – last booster after 4birthday

• MMR – 2 doses-­ first dose on or after first birthday and the second dose no less than one month later.

• Varicella Vaccine/Chickenpox­- first dose on or after the first birthday and the second dose no less than four weeks (28 days) after the first dose (or proof of disease and date documented by doctor)

3. DENTAL EXAMINATION due May 15 of current school year

4. VISION: EYE EXAMINATION REPORT due October 15 of current school year

Physical Examination and Immunization Requirements for Students Entering Grade 2

According to the Illinois School Code

• DENTAL EXAMINATION due May 15 of current school year

Compliance with this requirement is enforced by the State of Illinois. The dental form should be turned into the school health office as soon as it is completed.

Physical Examination and Immunization Requirements for Students Entering Grade 6

According to the Illinois School Code

1. HEALTH EXAMINATION – Conducted within one year (Must be dated within one year prior to the first day of school)

• Physical Exam – signed and dated by doctor

• Immunizations – signed and dated by doctor

• Medical History – completed and signed by parent

• Physical Education and Interscholastic Sports Participation - checked by doctor

• Mandatory Diabetes Risk Assessment

2. REQUIRED IMMUNIZATIONS:

• DTP/DtaP – 4 or more doses-­last booster after 4th birthday

• Tdap – 1 dose

• Hepatitis B – series of 3 doses

• Polio – 3 or more doses – last booster after 4th birthday

• MMR – 2 doses­- first dose after 12 months of age, 2nd dose no less than one month later

• Varicella Vaccine/Chickenpox –2 doses – first dose on or after the first birthday and the second dose no less than four weeks ( 28 days) after the first dose or (proof of prior varicella disease).

• MCV4 Vaccine (Meningococcal Conjugate Vaccine) – one dose

3. DENTAL EXAMINATION due May 15 of current school year

4. ATHLETICS - The physical examination will meet the requirements of a Sports Physical if your child wishes to participate in Cross Country next fall.

• Concussion Form

According to the Illinois School Code

ATHLETICS - If your child would like to try out for any sport, please complete the following two documents.

• IESA/IHSA Sport Physical Form

• Concussion Form