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Certificate of Child Health Examination Form
Physical examinations as prescribed by the Illinois Department of Public Health are required of all pupils any time within six months prior to their entrance into Kindergarten, upon entrance into the 6th grade, and if a transfer student.
Generally, the family physician will complete the form although the DuPage County Health Department will perform an examination if the family meets financial eligibility requirements determined by the Health Department.
Immunizations and booster immunizations against preventable diseases are also required of all children prior to or upon entering Kindergarten and 6th grade, and prior to or upon entering any grade if the child has not been previously enrolled in a school in Illinois.
The Illinois Department of Public Health requires the following school immunizations: Measles, Mumps, Varicella, Polio, DTP/DTaP/or Td Diphtheria, Tetanus, Pertusis, Hepatitis B, Rubella, Pneumococcal Conjugate, and Lead Test.
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Proof of Dental Examination Form
The Illinois Department of Health requires children in Kindergarten, 2nd grade, and 6th grade to have an oral health examination. Examinations must be performed by a licensed dentist, and he/she shall sign the Proof of School Dental Examination Form. Each child is required to present proof of examination by a dentist prior to May 15th of the school year.
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Eye Examination Report Form
The Illinois Department of Health requires children entering Kindergarten to have a vision examination performed prior to October 15th of the school year.
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