State of Illinois Certificate of Child Health exam (Physical Exam)
All students entering Pre-K, Kindergarten or first grade for the first time, incoming 6th grade students and any student who enters an Illinois school for the first time, must turn in a valid physical examination prior to the first day of student attendance.
Please note the Sate of Illinois Certificate of Child Health Examination form is the only form that will be accepted for incoming Pre-K, Kindergarten, incoming 6th graders and any student entering an Illinois school for the first time.
- Immunization records must be current and complete. A complete list of immunization requirements in the State of Illinois is available here http://dph.illinois.gov/sites/default/files/publications/idph-school-imm-requirements-fall-2017-051117.pdf
- Students who have a medical contraindication to receiving a vaccination should submit a letter from their physician dated on or before 10/15 of the current school year stating the following: 1-reason for medical contraindication, 2- date of next scheduled dose (if applicable), 3- signed and dated by physician.
- All required immunizations must be turned in on or before October 15th of the current school year.
If you have more than one student complete one for each student.
Please note, if your child qualifies under the "religious exemption" they are subject to exclusion from school in the event of a vaccine-preventable outbreak.
Students with life threatening allergies, asthma, seizure disorder, diabetes and any other significant health concerns require additional medical documentation. Pertinent confidential information is shared with teachers and staff as appropriate. If your child has special needs please contact the health office so we can prepare for your student's arrival at Komarek. Please note; health plans will need to be completed by your physician and turned in to the school nurse at the beginning of every school year. You can find health forms and/or the Medication administration form under the Health Forms tab http://www.komarekschool.org/apps/pages/index.jsp?uREC_ID=354553&type=d&pREC_ID=974583
Dental examinations are required for all students entering Kindergarten
and sixth grade
. The dental examination form is due by May 15th of the current school year. The student's final report card may be withheld until a completed dental examination is submitted, or the parents present proof that a dental examination will take place within 60 days after May 15th. Click on the link to obtain the Illinois Dental examination form http://www.idph.state.il.us/HealthWellness/oralhlth/DentalExamProof10.pdf
Eye examinations are required for each student entering Kindergarten or upon initial entry to an Illinois school
. The eye examination form must be submitted by October 15th of the current school year. Eye examination completed within 12 months prior to October 15th of the current school year are acceptable. The child's report card may be withheld if an eye examination is not submitted by October 15th of the current school year, the report card may be held until a completed eye examination is submitted or proof is submitted that an eye examination will take place within 60 days after October 15th of the current school year. Click on the link to obtain the State of Illinois Eye examination report http://dph.illinois.gov/sites/default/files/forms/eye-examination-report-050216.pdf
All medical forms (physical, dental, vision exams and immunizations) should be submitted to the school nurse for review as soon as possible after completion, to ensure your child will be compliant with all Illinois State health requirements.