Pleasantdale School District 107

Required Health Forms by Grade Level

Here is a list of the forms that need to be completed and returned for each student by 2023-2024 grade level:

Grade	Required Health Forms
Preschool	State of Illinois Certificate of Child Health Examination (Physical Exam with Immunizations Required only when first entering the Preschool program, NOT each year
Kindergarten	State of Illinois Certificate of Child Health Examination (Physical Exam with Immunizations) State of Illinois Eye Examination Report Proof of School Dental Examination
2^nd Grade	Proof of School Dental Examination
5^thGrade	Sports Physical Required only if participating in cross-country
6^thGrade	State of Illinois Certificate of Child Health Examination (Physical Exam with Immunizations) Proof of School Dental Examination
7^thGrade	Sports Physical Required only if participating is in an interscholastic sports program
8^th Grade	Sports Physical Required only if participating is in an interscholastic sports program

Every year we receive a large number of physical exam forms that are incomplete. In order to help you complete this form successfully, we have created a sample.

Other Medical Forms:

If you are not sure whether or not you need one of these forms, just ask!

.pdf

Please make copies of all your completed forms for your records!

Health Office

Health Forms

Health Requirements