Health Forms
On this page you will find the forms needed to help your student during school that may have a health condition, or need medication at school. The State of Illinois Physical Examination and Immunization form is also available here.
A Medication Administration Permission form is required for all medications in school, including those that can be bought over the counter without a prescription.
Link to the District u-46 Health Services Web page for futher district health information and forms:
u-46 Health Services Department
Forms:
* State of Illinois Physical Examination and Immunization form:
State of Illinois Child Health Examination Form English
State of Illinois Child Health Examination Form w/Spanish Parent Section
* Medication Administration Permission form:
Medication Administration Permission Form English
Medication Administration Permission Form Spanish
* Asthma Assessment and Asthma Action Plan forms:
Asthma Assessment Form Spanish
* Allergy Assessment and Emergency Plan forms:
Bee Sting Allergy Assessment Form English
* Food Allergy Assessment and Emergency Plan forms:
* Diabetes Care Plan forms:
Continuous Glucose Monitoring Parent Permission Form English
* Seizure Assessment and Emergency Plan forms:
Seizure Disorder Parent Assessment Form English
Seizure Disorder Emergency Care Plan