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Dear Kindergarten Parents/Guardians,

District 202 Health services welcomes you and your child as he/she begins elementary school!

The Illinois School Code Sec 27-8 requires all incoming Kindergarteners to have a health/physical examination with the required immunizations completed prior to the first day of school. Incoming kindergarteners must use the State of Illinois Certificate of Child Health Examination form.

• Immunizations must include:

  • Diphtheria/Pertussis/Tetanus (DPT/DTAP) – Four (4) or more doses, including a booster after the 4th birthday.

  • Polio (OPV/IPV) – Four (4) or more doses including a booster after the 4th birthday.

  • Measles/Mumps/Rubella (MMR) – Two (2) doses on or after 1st birthday.  The first dose at 12 months of age or older and the second dose no less than four weeks (28 days) after the 1st dose.

  • Varicella – Two (2) doses on or after 1st birthday or a statement from physician verifying disease.

Dates of ALL immunizations must be verified by a physician or healthcare provider. The Student Information (top of page 1) and Health History sections (top of page 2) on this form must be fully completed and signed by the parent/legal guardian. Furthermore, the physician must complete the diabetes screening section, and for students between the age of 1-6 years old, the lead risk questionnaire on the State of Illinois Certificate of Child Health Examination form.

Transfer students must present a health exam that was completed within one year prior to entry into an Illinois school. The transferring health/physical exam must also include the dates of all previous immunizations since birth. (Please take note of the above required Illinois School Code schedule of immunizations required). 

Plainfield School District #202 REQUIRES dental and eye exams for all incoming kindergarten students. Health Exam form/Dental Forms/Eye Exam Form may be obtained here.

Please complete and return all original forms to the school nurse. All paperwork is due to the health office by August 1st . Students not in compliance by the first day of school will be excluded from school until the required documentation is submitted to the health office.