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Required Health Forms

All children entering preschool, kindergarten, or sixth grade, and children who are newly-enrolled in District 112 are required by law to have a complete health examination by a licensed physician one year before beginning school.  Immunizations against communicable diseases are required and strictly enforced by the Illinois Department of Public Health. North Shore District 112 School Board policy requires that information regarding these medical procedures be presented to the nurse before the first day of school.

Health Examination and Immunization Form:

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Eye Examination Form

Form

Screening is also mandated for children who fall into these categories: Special Education, Teacher Referrals, and Transfer Students.

Vision screening will be completed during the school year, as mandated by the Illinois department of Public Health, for children in the following grades: Preschool, Kindergarten, Second Grade, and Eighth Grade.

Vision screening is not a substitute for a complete eye and vision evaluation by an eye doctor. Your child is not required to undergo the school vision screening if an optometrist or ophthalmologist has completed and signed a report form indicating that an examination has been administered within the previous 12 months, and that evaluation report is on file at the school. If your child wears glasses and is in one of the grades or groups to be tested, please made sure your child wears his or her glasses to school on the day of testing. Vision screening is not performed on students who already have glasses.

Illinois law requires that proof of an eye examination by an optometrist or physician who provides eye examinations, such as an ophthalmologist, be submitted to the school no later than October 15th of the year the child is first enrolled, or as required by the school for other children. The examination must be completed one year prior to the first day of school during the year that the child enters the Illinois school system for the first time. The parent of the child who is unable to obtain an examination must submit a waiver form to the school.

Hearing Screening

Hearing screening will also be completed during the school year, as mandated by the Illinois department of Public Health, for children in the following grades: Preschool, Kindergarten, First, Second, and Third Grades.

Screening is also mandated for children who fall into these categories: Special Education, Teacher Referrals, and Transfer Students.

Dental Examination Form

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Dental Waiver Form

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Illinois law requires all students have dental examinations by May 15th of the current school year administered by a licensed dentist in Kindergarten, second, and sixth grades.

Sports Physical Examination

Form

North Shore School District 112 also requires a sports physical examination by a licensed physician within one year prior to trying out for an interscholastic sport.  Following the exam, the second side of the Health Examination and Immunization Form should be fully completed by the parents and the physician. This examination is valid for one year. There are no immunization requirements for interscholastic sports.