District Nurse
jward@elmwood322.com
Phone: 309.742.4261 ext. 1123
Fax: 309.742.8833
REQUIRED DOCUMENTATION
STATE AND SCHOOL REQUIRED DOCUMENTATION
KINDERGARTEN
IN-STATE NEW/TRANSFER STUDENTS
OUT-OF-STATE NEW/TRANSFER STUDENTS
All new (non-transfer) Kindergarten students must have the following forms:
Eye Exam
Dental
Physical (w/ Lead Screening)
Birth Certificate
And the following vaccines:
2 MMR
2 Varicella (Chicken Pox)
3 or more Polio
4 or more DTaP
All Kindergarten students transferring in after the beginning of the year must follow the transfer student requirements to the right.
All in-state new and/or transfer students must have the following forms:
Permit For Release of Information (K-6)
Permit For Release of Information (7-12)
Additional forms required by grade level:
Second Grade
Dental
Sixth Grade
Dental
Vaccines required by grade level:
Sixth Grade
Meningitis
Tdap
2 Varicella (Chicken Pox)
2 MMR
3 Hepatitis
Ninth Grade
2 Varicella (Chicken Pox)
Twelfth Grade
Meningitis
All out-of-state new and/or transfer students must have the following:
Eye Exam
Physical
Birth Certificate
Additional forms required by grade level:
Second Grade
Dental
Sixth Grade
Dental
Vaccines required by grade level:
Sixth Grade
Meningitis
Tdap
2 Varicella (Chicken Pox)
2 MMR
3 Hepatitis
Ninth Grade
Dental
2 Varicella (Chicken Pox)
Twelfth Grade
Meningitis
CURRENTLY ENROLLED STUDENTS (1-12)
ALL STUDENTS IN AHTLETICS
Forms required by grade level:
Second Grade
Dental
Sixth Grade
Physical
Dental
Ninth Grade
Physical
Dental
Vaccines required by grade level:
Sixth Grade
Meningitis
Tdap
2 Varicella (Chicken Pox)
2 MMR
3 Hepatitis
Ninth Grade
2 Varicella (Chicken Pox)
Twelfth Grade
Meningitis
All students taking part in athletics must provide the following:
Sports Physical
If your child has a required physical for their particular grade level, that required physical does count as a sports physical. However, a sports physical cannot take the place of a required regular physical. Please ensure that your child's school office receives the proper kind of physical (dependent on the child's grade level). If you have questions, please contact your child's school office.
ALL STUDENTS WITH MEDICATION
All students requiring medication during the school day must have the following:
Medication Authorization Form
This form must be turned in before any medication is given to a student by the school nurse or other staff. It must be signed by a parent and an authorized health care provider.
LINKS TO FORMS
All forms are in printable, PDF format:
Forms are also available at each school office and the nurse's office. We provide physical forms here, for your convenience, but most often your health care provider's office will provide the regular or sports physical form themselves.
MEET OUR NURSE
