Required Forms
Immunization Guidelines
Immunization Waiver - MUST BE COMPLETED BY PHYSICIAN.
New to enrollment in Illinois for the first time:
Physical Form:
Vision Form:
http://www.idph.state.il.us/HealthWellness/EyeExamReport.pdf
Vision Waiver:
http://www.idph.state.il.us/HealthWellness/EyeExamWaiver.pdf
New enrollment within Illinois
Current records will be transferred, the nurse will contact if additional forms are needed.
PreK
1st year entry
Physical Form:
2nd year entry
No requirements
Kindergarten
Physical Form:
Dental Form:
http://www.idph.state.il.us/HealthWellness/oralhlth/DentalExamProof10.pdf
Dental Waiver:
http://www.idph.state.il.us/forms/ohpm/Dental%20Exam%20Waiver.pdf
Vision Form:
http://www.idph.state.il.us/HealthWellness/EyeExamReport.pdf
Vision Waiver:
http://www.idph.state.il.us/HealthWellness/EyeExamWaiver.pdf
Second Grade
Dental Form:
http://www.idph.state.il.us/HealthWellness/oralhlth/DentalExamProof10.pdf
Dental Waiver:
http://www.idph.state.il.us/forms/ohpm/Dental%20Exam%20Waiver.pdf
Sixth Grade
Physical Form:
Dental Form:
http://www.idph.state.il.us/HealthWellness/oralhlth/DentalExamProof10.pdf
Dental Waiver:
http://www.idph.state.il.us/forms/ohpm/Dental%20Exam%20Waiver.pdf
Ninth Grade
Physical Form:
Dental Form:
http://www.idph.state.il.us/HealthWellness/oralhlth/DentalExamProof10.pdf
Dental Waiver:
http://www.idph.state.il.us/forms/ohpm/Dental%20Exam%20Waiver.pdf
Twelfth Grade
Beginning with the school year 2015-2016 any child entering the 12th grade shall show proof of having received two doses of meningococcal conjugate vaccine prior to entering the 12th grade. The first dose shall have been received on or after the 11th birthday, and the second dose shall have been received on or after the 16th birthday, at least eight weeks after the first dose. If the first dose is administered when the child is 16 years of age or older, only one dose is required.
If your child has not received one dose of the meningitis vaccine (Brand name: Menactra or Manveo) after their 16th birthday prior to the first day of senior year they will be excluded from school.