District 41 Health Services
Physical-Immunization
Physicals
A physical examination is required for entrance into Preschool, Kindergarten, 6th grade, and/or when transferring from an out of state school. The health history portion of the physical examination form must be completed and signed by the parent in order for the physical to be valid. The exam must be dated within 1 year pior to the first day of the school year.
Physical examinations may be acquired through your primary medical provider. If you do not have a primary medical provider, you may contact your school nurse or the DuPage County Health Department for referrals to local health clinics that provide such services.
The physical exam must be documented on the Certificate of Child Health Exam. The form is available from the nurse's office, on the Illinois Department of Human Services website, or from your physician's office. The Illinois Department of Public Health Certificate of Child Health Exam form can be obtained by clicking the link at the bottom of this page.
All sections of the physical exam form, including the parent history section must be completed.
All physicals are due in the nurse's office before October 15 of each school year.
Physical Form
New 6th Grade Immunization Requirement
For the 2012-2013 school year, students entering 6th grade, must show proof of a recent Tdap vaccine on their 6th grade physical form.
Immunization Requirements for Preschool/Early Childhood/Pre-Kindergarten Programs
Diptheria, Tetanus, Pertussis - Three doses by 1 year of age. One additonal dose by 2nd birthday
Polio - Two doses by 1 year of age. One additional dose by 2nd birthday.
Measles, Mumps, Rubella - One dose on or after the 1st birthday but prior to 24 months of age.
Haemophilus influenzai type b - Per your doctor's schedule
Hepatitis B - Three doses for all children 2 years of age or older.
Varicella - One dose on or after the 1st birthday
Immunization Requirements for First Entry into School - Kindergarten or First Grade
Diptheria, Tetanus, Pertussis - Four or more doses of DTP/DTaP with last dose qualifying as a booster and received on or after the 4th birthday.
Polio - Three or more doses of the same type of Polio vaccine with the last dose received on or after the 4th birthday.
Measles - 2 doses of Measles Vaccine, the 1st dose must have been received on or after the 1st birthday and the second dose no less than 28 days later.
Mumps, Rubella - Vaccine administered on or after the 1st birthday.
Varicella - One dose on or after the 1st birthday.
5th Grade Students
Hepatitis B - Students entering 5th grade are required to have 3 doses administered at proper intervals.
Students Entering Other Grades
Diptheria, Tetanus, Pertussis - Three or more doses of DTP/DtaP or Td with the last dose received on or after the 4th birthday. Td booster every 10 years thereafter.
Polio - Three or more doses of Polio with the last dose received on or after the 4th birthday.
Measles - 2 doses of Measles Vaccine, the 1st dose received on or after the 1st birthday, and the second dose no less than 28 days later.
Mumps, Rubella - Vaccine administered on or after the 1st birthday.
Hepatitis B - Students entering 5th grade must have three doses administered at proper intervals.
Varicella - One dose on or after the 1st birthday.
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