- Deerfield Public Schools District 109
- The Department of Student Services
- Health Information and Forms
- Examinations & Immunizations
Student Services
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At a Glance, Health Requirements By Grade
See the full requirements & immunization information below this table!
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Health Exam Form
Health Exam
- Health Exam Form
- In lieu of the immunization and health examination, parents may submit the: Illinois Certificate of Religious Exemption to Required Immunizations and/or Examinations Form
Parent signature required
- Health Exam Form
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Eye Exam Form
Eye Exam
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Dental Exam Form
Dental Exam
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Permission to Administer Medication
Complete This Form: Permission to Administer Medication
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Food Allergy Emergency Care Plan
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Important Forms:
Food Allergy Emergency Care Plan
Individual Health Care Plan (IHCP)
Food in Our Schools
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A team of parents, staff and community members created District 109's Food Allergy Management Plan to positively influence the learning environment in all District 109 schools so all teachers could focus on teaching and students could focus on learning, safely and healthfully. This plan was designed specifically to address food allergies but can be used as a stepping stone for the successful management of other food-related issues (diabetes, celiac disease, and gluten sensitivities, etc.). The guidelines allow District 109 schools to be allergy-friendly and ensure that:
- Students are safe and able to learn academically and grow socially and emotionally in their schools
- Our school community would gain a better understanding of the needs of students with food allergies and other special dietary needs
- Parents of those students would gain comfort in that wider understanding of their children’s needs and would be able to easily access resources available to protect the health of children at school
- Staff would have easy-to-follow guidelines for food in classrooms and around the schools
The plan is reviewed regularly to ensure that it continues to meet those objectives.
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Diabetes Medical Management Plan
Please fill out this form: Diabetes Medical Management Plan
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Asthma Action Plan
Please Fill Out This Form: Asthma Action Plan
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Seizure Action Plan
Complete This Form: Seizure Action Plan
Requirements
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Requirements:
Students new to District 109 and students entering the grade levels below must submit required health forms. See details below.
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New Students
Health Exam and Immunization Records
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This form is required for all students who are new to District 109. Any child who has not returned the required documentation of a health examination will be excluded from school on October 15. According to The School Code of Illinois, physical examinations are required of all students prior to initial entry into school.
- Health Exam Form
- In lieu of the immunization and health examination, parents may submit the: Illinois Certificate of Religious Exemption to Required Immunizations and/or Examinations Form
- Parent signature required
Eye Exam
- This form is required for all students who are new to District 109. Documentation of the examination must be on file with the school nurse prior to October 15.
Dental Exam
- This form is required for all students who are new to District 109 by May 15 of that school year. The examination must have been performed within 18 months of the May 15 deadline.
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Students Entering Early Learners (Pre-Kindergarten)
According to The School Code of Illinois, the following are required:
Health Exam and Immunization Records
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Any child who has not returned the required documentation of a health examination will be excluded from school on October 15.
- Health Exam Form
- In lieu of the immunization and health examination, parents may submit the: Illinois Certificate of Religious Exemption to Required Immunizations and/or Examinations Form
- Parent signature required
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Students Entering Kindergarten
According to The School Code of Illinois, all children entering Kindergarten must submit a recent physical examination form. All children who are new to District 109 must also submit an Eye Exam and Dental Exam Form.
Health Exam and Immunization Records
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Any child who has not returned the required documentation of a health examination will be excluded from school on October 15. According to The School Code of Illinois, physical examinations are required of all children entering Kindergarten.
- Health Exam Form
- In lieu of the immunization and health examination, parents may submit the: Illinois Certificate of Religious Exemption to Required Immunizations and/or Examinations Form
- Parent signature required
Eye Exam
- This form is required for all students who are new to District 109. Documentation of the examination must be on file with the school nurse prior to October 15.
Dental Exam
- This form is required for all students who are new to District 109 by May 15 of that school year. The examination must have been performed within 18 months of the May 15 deadline.
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Students Entering Grade 2
Dental Exam
- This form is required by May 15 of that school year. The examination must have been performed within 18 months of the May 15 deadline.
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Students Entering Grade 6
According to The School Code of Illinois, physical examinations are required of all students prior to initial entry into school and upon entrance into sixth grade.
Health Exam and Immunization Records
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Any child who has not returned the required documentation of a health examination will be excluded from school on October 15. According to The School Code of Illinois, physical examinations are required of all students upon entrance into sixth grade.
- Health Exam Form
- In lieu of the immunization and health examination, parents may submit the: Illinois Certificate of Religious Exemption to Required Immunizations and/or Examinations Form
- Parent signature required
Dental Exam
- This form is required for all students who are new to District 109 by May 15 of that school year. The examination must have been performed within 18 months of the May 15 deadline.
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Immunizations
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In Illinois, children enrolled in any grade need proof of up-to-date immunizations. Here are some specific requirements:
- Students entering sixth grade must show proof of recent meningococcal conjugate vaccination (MCV).
- Hepatitis B vaccination is required for students entering sixth grade.
- Students must show proof of having received two doses each of live rubella and mumps virus vaccines.
- Students entering kindergarten or sixth grade for the first time must show proof of having received two doses of varicella (chickenpox) vaccine.
- The State of Illinois requires that all students entering grades 6, 7, and 8 provide proof of the Tdap immunization to protect against whooping cough. This immunization has been recommended for children 10 years and older for several years, and most local physicians have been including this as part of the immunization routine.
The Illinois Department of Public Health (IDPH) provides this schedule of immunization requirements. You can visit the IDPH website for more information about immunizations.
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If you have questions, please contact District 109 nurse Mary Phelps, RN, at mphelps@dps109.org or 847-945-1075 x5153.