Health Requirements 

                 2021-2022 Upcoming Vision and Hearing Screenings
Vision and hearing screening are required annually, once a child begins school. Vision screening is required at grades K, 2, and 8. The student is not required to undergo this 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 is on the health record at school.
Hearing screening is required at grades K, 1, 2, and 3. Screening for both vision and hearing must be completed annually on all children in special education, new to the district, and teacher referrals. Parents may request vision and hearing screenings for any child at any time regardless of grade. Parents will be notified of the results.

When: Screenings will be conducted on Wed., December 1st, 2021
If you have any questions please contact Mrs. Chapp, School Nurse 708-447-8030 Ext. 120 or gchapp@komarek94.org.
Se requieren exámenes de la vista y del oído para los siguientes grados: Kindergarten, 1º, 2º, 3º y 8º grado.
Cuándo: Las proyecciones se llevarán a cabo el Miércoles, Deciembre 1
Si tiene alguna pregunta, comuníquese con la Sra. Chapp, Enfermera de la escuela 708-447-8030 Ext. 120 o gchapp@komarek94.org.





Health Requirements for the 2021-2022 School Year


 In preparation for any upcoming medical, dental, or vision exam appointments you may be planning for your child, we are providing a list of the physical,  dental, and vision requirements per the Illinois School Code for the 2021-2022 school year.


The following are Illinois School health requirements:

State of Illinois Certificate of Child Health exam (Physical Exam) with up to date immunizations:

  • Pre-Kindergarten
  • Kindergarten
  • 6th Grade 


Print the State of Illinois Certificate of Child Health Examination form (physical form).

Date must be within 12 months prior to the student's start date in the district.

  • A parent or legal guardian must complete, sign and date the health history portion on the second page of the health examination form. 
  • If the student is required to have a sports physical, the Certificate of Child Health examination may be accepted as proof of examination for interscholastic sports. 

Please note the State 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 https://www.isbe.net/Documents/Clarification-immunization-requirements-school.pdf

  • All required immunizations must be turned in on or before October 15th of the current school year or your child will be excluded from school.


Religious Exemption

In order for a student to qualify under "religious exemption" the following form needs to be submitted to the school nurse to waive immunizations and/or physical examinations due to religious beliefs https://www.isbe.net/Documents/immun-exam-gdlns-religious-exempt.pdf 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. 


Dental Examination

Dental examinations are required for all students entering:

  • Kindergarten 
  • Second grade
  • Sixth grade 
Click on the link to obtain the Illinois Dental examination form



Eye Examination

Eye examinations are required for students entering Kindergarten. 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. 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

Please contact the Health Office with any questions, 708-447-8030 ext. 120 or email health@komarek94.org
Geana Chapp, MSN-Ed, RN