HEALTH FORMS

Certificate of Child Health Examination: State of Illinois Certificate of Health Exam

Religious Exemption: Certificate of Religious Exemption Form

Eye Examination: Eye Examination Report

Eye Examination Waiver: Eye Examination Waiver Form

Dental Examination: School Dental Examination Form

Dental Examination Waiver: Dental Examination Waiver Form

Sports Physical: Pre-participation Examination - IHSA

Medication Permission: Medication Authorization Form

Forms for identified health concerns:

These are examples, other similar forms are acceptable.

Allergy and Anaphylaxis Emergency Action Plan: Allergy and Anaphylaxis Emergency Plan

Asthma Action Plan: Asthma Action Plan | Illinois Department of Public Health

Seizure Action Plan: Seizures/Epilepsy: Seizure Action Plan

Diabetes Medical Management Plan: Diabetes Medical Management Plan