Examinations & Immunizations

Health Requirements by Grade

Below is a quick glance at what are required health forms by grade level. For a more detailed view please scroll down to see our requirements by grade level.

Required for students entering the following grades...	HEALTH	EYE	DENTAL
Early Learners	X
Kindergarten	X	X	X
Grade 2			X
Grade 6	X		X
NEW to district students (K-8)	X	X	X

If you have questions, please contact District 109 nurse Mary Phelps, RN. For health forms and more information, please view the tabs below.

Mary Phelps, RN

District Nurse

Please submit your most recently updated health forms below!

Submit Health Forms Here

Medication in School

In order for the school nurse to administer any medication to a student, prescription or nonprescription, during the school day, a Permission to Administer Medication form must be completed by the student's physician and on record with the student's school.

Permission to Administer Medication (Prescription or Nonprescription) Form Here

Requirements by Grade Level

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

New Students

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 15th. According to The School Code of Illinois, physical examinations are required of all students prior to initial entry into school. Parent signature is 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 15th.

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 15th deadline.

Students Entering Early Learners (Pre-Kindergarten)

Health Exam and Immunization Records

This form is required for all students who are entering the Early Learners program for the first time. Any child who has not returned the required documentation of a health examination will be excluded from school on October 15th. According to The School Code of Illinois, physical examinations are required of all students prior to initial entry into school. Parent signature is required.

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

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 15th.

Dental Exam

This form is required for all students entering kindergarten by May 15 of that school year. The examination must have been performed within 18 months of the May 15th deadline.

Students Entering Grade 2

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

Dental Exam

This form is required for all students entering 6th grade in District 109 by May 15 of that school year. The examination must have been performed within 18 months of the May 15th deadline.

6th Grade Immunizations Requirements

In Illinois, children enrolled in any grade need proof of up-to-date immunizations. Here are some specific requirements for 6th grade entry:

Students entering sixth grade must show proof of recent meningococcal conjugate vaccination (MCV).
Hepatitis B vaccination series is required for students entering sixth grade.
The State of Illinois requires that all students entering grade 6 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.

Middle School Athletic Physical Guidelines

As a reminder, your certificate of child health examination and/or your pre-participation examination form expires one year after the initial exam. If your child wants to participate in a sport (including tryouts) one year after their most recent exam, they must obtain an updated certificate of child health examination and/or your pre-participation examination form before participating. For example, if your child receives a certificate of child health examination and/or your pre-participation examination form in February 2025 and plans on participating in track in the spring of 2026, they would be required to obtain an updated certificate of child health examination and/or your pre-participation examination form before they can tryout or participate.

Immunization Schedule

The Illinois Department of Public Health (IDPH) provides this schedule of immunization requirements. You can visit the following links for Influenza and influenza vaccination information. You can visit the following links for Meningococcal and Meningococcal Vaccine information. You can visit the IDPH website for more information about immunizations.

View the District 109 immunization summary here

Individual Health Forms

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In This Section

Examinations & Immunizations

Health Requirements by Grade

If you have questions, please contact District 109 nurse Mary Phelps, RN. For health forms and more information, please view the tabs below.

Mary Phelps, RN

Please submit your most recently updated health forms below!

Medication in School

Requirements by Grade Level

New Students

Students Entering Early Learners (Pre-Kindergarten)

Students Entering Kindergarten

Students Entering Grade 2

Students Entering Grade 6

6th Grade Immunizations Requirements

Middle School Athletic Physical Guidelines

Immunization Schedule

Individual Health Forms

Immunization Summary by Building

Kipling

Walden

South Park

Shepard

Wilmot

Caruso

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Links & Resources