All students that are enrolled in Itasca School District #10 must have physical examinations and immunizations on file. A dental examination is strongly encouraged but it is not yet required by law.

K-Prep

Kindergarten

5th Grade

6-8th Grade Sports/Cheerleading

Transfer Student

Health Requirements for Children Entering K-Prep:
Illinois State Law requires that children entering preschool have the following items. Please be sure that the physical form is completed entirely BEFORE you leave the doctor’s office! The form will require these items:

IMMUNIZATIONS:
• DPT or DtaP – Diptheria, Tetanus, Pertussis: A minimum of three doses, spaced at least 2 months apart.
• Polio: A minimum of two doses, spaced at least 2 months apart.
• Hepatitis B: A total of three doses, with 1-2 months between the first 2 doses, and at least 4 months between the 2nd & 3rd doses.
• HIB – Hemophilus Influenza B: A series of 3 or 4 doses, depending on the age the series was begun, and the manufacturer of the vaccine.
• MMR – Measles, Mumps, Rubella: A minimum of 1 dose, and the first dose must not have been given before 12 months of age. EVEN A DOSE GIVEN ONE DAY BEFORE THE FIRST BIRTHDAY IS NOT ACCEPTED.

PHYSICAL EXAMINATION:
• Must include Blood Pressure, Height, and Weight.
• Physician Signature is required on two sections: Immunizations at the top, and at the bottom after the physical exam portion. A date is also required.
• Complete the parent portion indicating child’s health history.

If you have any questions or have a concern about your child’s health or medication needs, call Mrs. Barchfeld, School Nurse, at (630)773-1232, x 604.

Health Requirements for Children Entering Kindergarten:
Illinois State Law requires that all children entering kindergarten have the following items on file. Please ensure that all highlighted parts of the physical and immunization sections of the form are complete before you leave your health care provider’s office!

IMMUNIZATIONS
Dates of ALL vaccinations must be on the form!

• DPT or DtaP - Diphtheria, Pertussis, & Tetanus: Minimum of 4 doses, the last one received AFTER AGE 4 years. All dates must be recorded on the form by month-date-year.
• Polio: Minimum of 3 doses, the last one received AFTER AGE 4 years.
• MMR – Measles, Mumps, Rubella: First dose given at age 12 months or later.
• Measles – Second Dose given at least ONE MONTH after the first dose.
• Physician signature is required to verify immunizations.

Optional:
• A TB skin test (tine, PPD, Mantoux) is recommended by Illinois Department of Public Health. It is not required for school entry.
• Hepatitis B vaccination is not required for kindergarten. It is required for 5th grade.

PHYSICAL EXAMINATION
• Must include Blood Pressure, Height, and Weight.
• Requires date and physician signature.
• Physician must indicate approval for gym and sports participation by checking the boxes.
• Parent must complete the health history of the form, sign it, and date it (upper left corner).

Return the completed form to the school office as soon as possible.

If you have any questions or have a concern about your child’s health or medication needs, call Mrs. Barchfeld, School Nurse, at (630)773-1232, x 604.

Health Requirements for Children Entering 5th Grade:
PHYSICAL EXAMINATION:
A physical examination is required within 1 year of the first day of the 5th grade school year.

IMMUNIZATIONS:
Hepatitis B- a series of 3 shots: Shots 1 and 2 are received one month apart, and shot 3 is received 5 months after shot 2. If more time has elapsed between any of the shots, the series DOES NOT have to start over. The student continues to receive the remaining immunizations.

If you have any questions or have a concern about your child’s health or medication needs, call Mrs. Barchfeld, School Nurse, at (630)773-1232, x 604.

Health Requirements for Children Participating in 6th, 7th, and 8th grade Sports/Cheerleading:
Students who wish to participate in sports or cheerleading must have a sports physical prior to trying out for the activity each school year. Itasca District #10 hosts low cost sports physical once each year, usually in August. The physical examinations are conducted by Dr. Michael Fragen and his associates. The gym at Peacock is where they are done. A student may attend without a parent, however, a completed health history and a signed consent form is required with pre-payment.

If you have any questions or have a concern about your child’s health or medication needs, call Mrs. Maney, School Nurse, at (630)773-1232, x 622.

Transfer Students
Students who are coming to our school from another school are also required to have health records on file. These may be sent from the previous school, or the parent may provide a copy at registration.
If a student is coming from another state or country, a physical examination and/or additional immunizations may be necessary.

Please be aware that a student may not be allowed to stay in school if the requirements are not fulfilled according to district policy and Illinois state law.

If you have any questions or have a concern about your child’s health or medication needs, call Mrs. Barchfeld, School Nurse, at (630)773-1232, x 604.

Further information about school health requirements may be viewed on the Illinois Department of Public Health web site:
http://www.idph.state.il.us/about/k12sir.htm