Student Health Requirements

Illinois School Code requires any student entering 9th grade, 12th grade, or transfer student to meet certain health requirements for school attendance. Glenbrook High School District 225 Board of Education Policy reserves the right to exclude students from school, as of October 15 of each school year, if these requirements are not met and required documentation is not submitted.

Health Requirements By Grade

Freshman Year

Certificate of Child Health Examination Form (School Physical)

Can only be accepted if dated within 12 months from the first day of school.
A physical exam form is not considered complete and in compliance with state requirements unless the health history section on page two is filled out and signed by a parent/guardian.
The exam must be completed by a licensed health care provider (MD, DO, APN or PA).
Complete and update immunization records for age and grade level per Illinois Department of Public Health (IDPH) requirements.
A ninth-grade physical meets the requirement of a sports physical if the student will be participating in a school-sanctioned athletic team.

Form

Certificate of Child Health Examination Form in PDF (English)

Certificate of Child Health Examination Form in PDF (Spanish)

Proof of School Dental Examination Form

The examination must have taken place within 18 months prior to May 15 of the school year.

Form

Proof of School Dental Examination Form in PDF (English)

Proof of School Dental Examination Form in PDF (Spanish)

Sophomore Year

Junior Year

Senior Year

Meningococcal Vaccination - A second dose given on or after the 16th birthday and an interval of at least 8 weeks after the first dose. Only one dose is required if the first dose was received at 16 years of age or older.
No additional physical or immunizations are needed if the student is up-to-date and the student is not a new to Glenbrook student.
For students with a chronic medical condition, an updated care plan needs to be submitted annually.

Transfer Student

A student transferring to Glenbrook High School, regardless of grade, must meet specific requirements to attend school.

Proof of completion must be submitted within 30 days of enrollment.

Requirements for Transfer Students

Requirements for Transfer Students

Certificate of Child Health Examination Form (School Physical)

The form must be dated within 12 months prior to entry into an Illinois School. Illinois Certificate of Child Health Examination Form must be completed, or on a comparable form that includes all required elements.

State of Illinois Eye Examination Report (Eye Exam)

Any student enrolling for the first time in a public, private, or parochial school in the State of Illinois is required to present proof of an Eye Examination performed by a licensed optometrist or ophthalmologist.

Navigation

Vision and Hearing Screening Mandates

In accordance with the Illinois Department of Public Health, hearing screening must be provided annually for students who are enrolled in special education, have been referred by a teacher, or are transfer students. These screening services shall be provided in all public, private, and parochial schools. In lieu of the screening services required, a completed and signed report form, indicating the child had an ear examination by a physician and an audiological evaluation completed by an audiologist within the previous 12 months, is acceptable.

Vision screening must be provided annually for students who are enrolled in special education, have been referred by a teacher, or are transfer students. Such screening services shall be provided in all public, private and parochial schools. In lieu of the vision screening services required, a completed and signed report form, indicating that an eye examination by a doctor specializing in diseases of the eye or a licensed optometrist has been administered within the previous 12 months, is acceptable.

Submitting A Form

Forms can be submitted to the Nurses' Office through the following means:

Mail them
Drop them off at the school's main entrance
Fax
Email

We recommend retaining a copy of all forms for your records.

Important Due Dates

Physical exams and immunization records should be submitted to the Nurses’ Office by July 1. If not received by the first day of school, they are considered past due, and a student may be excluded from school if they remain non-compliant on October 15.

Care Plans

Ninth grade dental exams are due by May 15 of the 9th-grade year.

Forms

Examination

Waivers and Exemptions

Care Plans

Students with chronic medical conditions are required to submit a care plan to the school’s nurses’ office.

All medications listed on a care plan must have a Medication Authorization on file.

For your convenience, care plans for common conditions are provided.

Medication Authorization

Athletic Physical

Pre-Participation Examination (Athletic Physical)

A 9th-grade or transfer student’s certificate of child health examination (physical) meets the requirement of a pre-participation examination (athletic physical) if the student will be participating in a school-sanctioned athletic team. Once submitted and approved, the athletic office will have access to the physical for athletic eligibility purposes.

An examination is valid for 364 days from the date of completion. In order for a student to be eligible to participate in an athletic school program, they must have a valid physical on file. During a student's 10th, 11th, or 12th-grade year may elect to have a pre-Participation examination (athletic physical) completed instead of a child health examination (physical).

Immunization Data

Questions