Requirements per Grade Level

Entering Kindergarten

-Complete Physical Form

-Vaccination Record with:

2 MMR
2 Varicella
3 or 4 Polio (depends on series)
4 or 5 DTap (depends on series)
3 Hep B (not required but must be completed for 6th grade year)

-Dental Exam Form

-Eye Examination Form (must be done by a doctor of optometry, not just the regular pediatrician eye test)

Entering Second Grade

-updated Dental Exam Form

Entering Sixth Grade

-Complete Physical Form

-Vaccination Record with:

tDap
Meningococcal
3 Hepatitis B

OR: updated Exemption Waiver for VACCINES. Student must still have complete physical turned in for sixth grade.

-updated Dental Exam Form

For all other years, if you have updated forms you may still submit them to me as you receive them and I will file them in your child's medical folder here at the Health Office.

Please DO NOT submit the original to me- it is always good to have a backup copy kept for your own records at your house.

If you scan and send forms via email: scoyle@pccharterschool.org Fax: 847-543-9744 Attn: SCHOOL NURSE PCCS

For grades 5-8, a current sports physical must be on file if your child would like to participate in any PCCS sports. The physical form is good for 395 days (13 months) from the time of the previous exam. In lieu of this form, your child's regular yearly physical form can be used if it is current. Please check with the school nurse if you have any questions regarding form status- I will try my best to notify you ahead of time of upcoming expiration dates, but cannot guarantee that this will always happen.

Sports Physical (grades 5-8)

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