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Health Forms

Health Forms

All health documents must be submitted electronically by uploading to: CHSD230 Student Medical Information


State of Illinois Certificate of Child Health Exam
Required for an incoming freshman or new to the Illinois public school system
Certificate of Child Health Exam (Spanish) 

Dental Examination 
Required for an incoming freshman or new to the Illinois public school system
Dental Exam (Spanish) 

Eye Examination  
Required for students entering the Illinois School System for the first time.

Medication Authorization 
Required for medication prescribed during school hours (prescription or over-the-counter). The medication authorization form must be completed by your student’s doctor, kept on file in the health office and updated every school year. Students with asthma, diabetes, epilepsy, and life threatening allergies require additional medical documentation (link to Health/special forms).  

IHSA Preparticipation Sports Physical Form
Required for student athletes grades 10, 11, 12 

 

Exemption Forms

State of Illinois Religious Exemption Form 

State of Illinois Dental Waiver Form

Dental Exam Waiver (Spanish) 

State of Illinois Eye Exam Waiver Form