All students must be current on exams and immunizations as required by both the State of Illinois and the Diocese of Belleville.
State of Illinois Health Exam Requirements
Students will NOT be able to attend school after October 15 unless ALL required information is received. Your health, dental and vision providers should have the proper forms available. IMPORTANT: A Sports Physical does not fulfill the State of Illinois requirements listed below.
All new students not coming from an Illinois school must complete a Physical Exam, Dental Exam and and an Eye Exam.
All new students coming from an Illinois school must fulfill the requirements below:
PLEASE NOTE: A portion of the Physical Exam Form is the PARENT’S RESPONSIBILITY! Parents, please complete:
STUDENT’S DEMOGRAPHIC INFORMATION (front)
HEALTH HISTORY – Allergies, Medication, etc.
Parent/Guardian signature
Requirements by Grade Level:Kindergarten Students:
State of Illinois Health Exam
Complete immunization record signed or stamped by a doctor
Dental Exam on Illinois form dated by May 15 of this school year
Eye Exam on Illinois form completed dated within one year of the first day of school
Birth Certificate
Second Grade Students:
Dental Exam on Illinois form dated by May 15 of this school year
Sixth Grade Students:
State of Illinois Health Exam
Complete immunization record signed and stamped by a doctor
Dental Exam on Illinois form dated by May 15 of this school year
