Prairie Hill School District #133
Important Health Forms
Please click the links for specific health forms applicable to your student.
If you have any questions related to any of these forms, do not hesitate to contact the nurse for your school (contact information on the Home page).
Students will be excluded from school if their physical and immunizations are not turned into the health office by October 15th. Dental forms are due by May 15th.
Please correspond with the school nurses via email. Completed medical forms may be faxed to the school office.
Willowbrook: 844.272.8075 Prairie Hill: 866.804.6443
- Physical Examination
- Up to Date Immunizations- including 3 doses of Hepatitis B Vaccine
Kindergarten
- Physical Examination
- Dental Examination
- Eye Examination
- Up to Date Immunizations- including 2 doses of Varicella Vaccine and 2 doses of MMR vaccine
Second Grade
- Dental Examination
Sixth Grade
- Physical Examination
- Dental Examination
- Up to date immunizations- including 2 doses of Varicella Vaccine, 1 dose of Tdap, 1 dose of Meningococcal Vaccine
2024-2025 PHSD Health Information Form (ALL students must turn in this form by the FIRST day of school)
Medication Authorization Forms (MUST have parent and physician signature in order to have prescription or over-the-counter medication administered to your student at school. A new form must be filled out for each school year. As per policy and state law, absolutely no medications will be administered without full completion of these forms.
2024-2025 Over-the-Counter Occasional Medication Authorization Form
2024-2025 Prescription Medication Authorization Form (prescription medication to be given at scheduled times during school hours)
NOTE: All prescription medication must be brought in by a parent/guardian and picked up by a parent/guardian. No controlled medication will be accepted from or returned to students. All prescription medication must be in the prescription container clearly displaying the student's name, the medication and the dose.
Examinations
State of Illinois Sports Examination Form (all students participating in sports will need a sports physical on file in the health office prior to try-outs)
Vaccinations
Care & Action Plans - Please submit a hard copy of action plan to the front office or nurse. All students with asthma, diabetes, food/anaphylactic allergies, and seizures must complete plan in conjunction with personal physician. Students who may need to be treated for migraines while at school should also complete the condition specific plan. To have food substitution for food allergies provided, form must be completed by physician. These forms must be filled out each school year.
BinaxNOW Covid Testing Information & Authorization Form (a new form must be filled out and submitted each school year)