1. PHYSICAL EXAMINATION
   1. New form required for current Illinois students in Kindergarten, 6^th,9^th grade.
   2. Illinois physical required for students from out of state or entering public school for the first time.
   3. Physical must be on the most current version of the Certificate of Child Health Examination.
   4. Physical exam must be dated within 1 year of the first day of the current school year.
   5. The following information must be included on the physical exam:

   • LEAD ASSESSMENT documentation, indicating the health care provider has addressed lead poisoning, is required.

   • DIABETES SCREENING portion of the exam form must be completed. 
   • HEALTH HISTORY SECTION needs to be completed and signed by the parent or legal guardian. This is required.
   • TUBERCULOSIS SKIN TEST is strongly recommended but not required. 

2.     IMMUNIZATIONS:  Month/day/year for each and must be verified by a health care provider.

1. POLIOMYELITIS: Three or more doses of polio (IPV or OPV), at the appropriate intervals, with the last dose being a booster and having been received on or after the 4^th birthday.  Children who receive any combination of IPV and OPV doses must receive four doses.

2. DIPTHERIA, TETANUS, PERTUSSIS (DTP): Four or more doses of DTP, at appropriate intervals, with the last dose being a booster and having been received on or after the 4^th birthday.

3. MEASLES (rubeola): TWO DOSES of measles vaccine, the first being on or after 12 months of age and the second dose no less than 1 month after the first OR shows proof of immunity (lab evidence of measles immunity or prior measles disease verified by date and physician signature).

4. MUMPS: At least one dose of mumps vaccine at 12 months of age or older.

5. RUBELLA (3 day measles): At least one dose of rubella vaccine at 12 months of age or older.

6. VARICELLA (chicken pox): One dose on or after 12 months of age or alternate proof of prior varicella disease. (See Alternate Proof of Immunity #2 on IDPH examination form). New guidelines recommend two doses, although only one dose is required for school.

7. HEPATITIS B: Children entering the fifth grade must show evidence of having received 3 doses of hepatitis B vaccine. The first 2 doses must have been received no less than 4 weeks (28 days) apart.  The interval between the second and third dose must be at least 2 months.  The interval between the first and third dose must be at least 4 months. 

Dental Examination (Kindergarten, 2nd, and 6th grade)

1. Most tooth decay may be prevented with appropriate amounts of fluoride and with the use of dental sealants applied when the first permanent molars erupt at about age 6 years and second permanent molars erupt at about age 12 years.
2. Dental exams must be completed on the IDPH proof of school dental exam form and is due on May 15th of the child's K, 2nd, or 6th grade school year. Dental exams must be dated within 18 months prior to the May 15th deadline.
3. The State has developed a waiver for children who show an undue burden or a lack of access to a dentist.

 EYE EXAMINATION

1.  Kindergarten and students from out of state or entering public school for the first time must show proof of having an eye exam performed by an optometrist or a physician licensed to practice medicine in all of its branches.
2. Eye exam must be completed on the State of Illinois Eye Exam Report Form and must be dated within 1 year of the first day of the current school year.

3. The State has developed a waiver for children who show an undue burden or a lack of access to an eye doctor. Please contact the nurse in your child’s school if assistance is needed.

RELIGIOUS OBJECTION