Students new to District 109 and students entering the grade levels below must submit required health forms. See details below. 

Health Exam and Immunization Records

• 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.
  • Eye Exam Form
  • Eye Exam Waiver Form

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.
  • Dental Exam Form
  • Dental Exam Waiver Form

According to The School Code of Illinois, the following are required:

Health Exam and Immunization Records

• 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

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

• 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.
  • Eye Exam Form
  • Eye Exam Waiver Form

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.
  • Dental Exam Form
    
  • Dental Exam Waiver Form

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.
  • Dental Exam Form
  • Dental Exam Waiver Form

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

• 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.
  • Dental Exam Form
  • Dental Exam Waiver Form