Health Services

HEALTH INFORMATION 2016-2017

Click here for the Health Examination Form

Click here for the Dental Exam Form

FORMS

Care Plan Forms for Health Conditions

REQUIREMENTS BY FIRST DAY OF SCHOOL

 Kindergarten:

Current Physical including:  Lead screening and Diabetes Screening (on physical)

Immunizations

  Dtap - 4 or more

  Polio - 3 or more

  Measles - 2

  Mumps - 2

  Rubella - 2

  Hep B - 3

  Varicella - 2

Vision Exam: by an Optometrist

Dental exam:  Turn in by May 1, 2017

Parent Consent Form

 

1st Grade:

Parent Consent Form

Proof of 2 MMR & 2 Varicella

 

2nd Grade:

Parent Consent Form

Dental exam:  Turned in by May 1, 2017

 

3rd Grade:

Parent Consent Form

 

4th Grade:

Parent Consent Form

 

5th Grade: 

Parent Consent Form

 

6th Grade:

Current Physical (sports physical does not qualify)

Dental exam:  Turned in by May 1, 2017

Immunizations:  Proof of 2 MMR, 2 Varicella, 1 Tdap, 1 meningococcal-after 11th birthday

  Dtap - 4 or more

  Polio - 3

  Hep B - 3

Parent Consent Form

 

7th Grade:

Parent Consent Form

Proof of 2 MMR & 2 Varicella

 

8th Grade:

Parent Consent Form

Proof of 2 MMR & 2 Varicella

 

9th Grade:

Parent Consent Form

Proof of Immunizations:

  DTAP - 4 or more

  Polio - 3

  MMR - 2

  Hep B - 3

  Varicella - 2

  Meningococcal - 1

  Tdap

 

10th Grade:

Parent Consent Form

Proof of 2 MMR & 2 Varicella

 

11th Grade:

Parent Consent Form 

Proof of 2 MMR & 2 Varicella

12th Grade:

Immunizations: Proof of 2 meningococcal vaccines (One must be after age 16)

      Proof of 2 MMR & 2 Varicella

Parent Consent Form

 

Parent Consent forms are available online or at school registration.  These forms need to be filled out each year, for medical concerns and for the student to be able to take Tylenol or Ibuprofen at school as needed. 

If you have any questions please contact me, Sherry Hafer at 285-8614, or contact your school nurse. 

Thanks for your cooperation

Sherry Hafer RN

 

 Meet Your Nurse

Sherry Hafer

815-284-7723

 

District Health Coordinator

 

Vanessa Rubright815-284-7723

Dixon High School

Chris Pierce815-284-7725

 

Reagan Middle School/Madison School

 

 Melissa Feit 815-284-7724 Jefferson School
Joyce Faivre815-284-7727Washington School
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