State of Illinois Mandatory Health Requirements for Students

Physical Exam

(For 9th Grade & Transfer Students)

As a requirement for all incoming ninth graders, students are required to submit a State of Illinois Certificate of Child Health Examination form (español). Forms must be dated within twelve (12) months of the first day of school. A parent/guardian must fill out and sign the parent/guardian health history section and note any health condition, disabilities, allergies, and/or medications.

Please note: an Illinois High School Association (IHSA) sports physical form MAY NOT be submitted for ninth grade enrollment purposes as it lacks much of the required information regarding a student's health history and status. Transfer students must provide all current updated immunizations, health records and TB Skin test requirements. The student has 30 days for all completed records to be on file with the Health Service Office.

• Physical Form (Español).

Eye Exam

(Transfer Students)

An eye exam is required for all transfer students from out of the state of Illinois. Illinois law require all students transferring to an Illinois school from out of state for the first time to complete an eye exam.

• Eye Exam
• Eye Exam Waiver

Dental Examination

(9th grade)

A dental exam is also required for all incoming ninth graders. Dental exams may be submitted if they are dated on or after November 15 of the previous school year. Plese note: school dental exams must have been completed within 18 months prior to the May 15th deadline.

• Dental Exam Proof form (Español)
• Dental Exam Waiver form (Español)

Meningitis

District 211 12th grade students must provide proof of the meningococcal vaccination (MCV4) given on or after the student's 16th birthday. Parents and guardians are advised to consult with their child's healthcare provider to determine if they are in compliance.

Medication Authorization Form

Students with prescriptions and other over the counter medications to be taken during the school day are required to complete and submit a Medication Authorization Form. This form must be submitted annually and/or whenever a prescription has been changed.

• Medication Authorization Form (Español)

Tylenol and Advil are stocked in the health office and may be given as needed with a completed Tylenol/Advil Authorization Form; parent/guardian and medical provider signatures are required.

Religious Exemption Requests

The Illinois Department of Public Health and Illinois State Board of Education require that the Illinois Certificate of Religious Exemption Form be completed by the parent/guardian and signed by the primary care provider if religious exemption is requested. If you have any further questions regarding this law, please contact the school nurse.

Guidelines for Administration of Medication

District 211 is committed to the health and safety of its student body. Any students who need to take medications throughout the school day may do so, but for the safety of our students and staff, specific procedures must be followed.

If it is determined that medication must be given to a student at school:

Prescriptions

All prescription and over-the-counter medication will be administered by a school nurse. Students are not allowed to carry medications, with the following exceptions:

• Students with Asthma may carry an inhaler.
  • Asthma Action Plan
• Students with IDDM may carry their insulin and supplies.
  • Diabetic Action Plan
• Students with severe allergies may carry an Epi-Pen.
  • Allergy and Anaphylaxis Action Plan

Permission Forms

A Permission Form to Administer Medication must be completely filled out and signed by the student’s parent or guardian as well as a licensed prescriber, and on file in the Nurse’s Office.

• Medication Authorization Form (Español)

Some over-the-counter medications are stocked by our nurses. These include: ibuprofen, Tylenol, and Benadryl. Any prescription medications must be brought to the Nurse's Office by a parent or guardian in its original container.

IMPORTANT - school nurses will dispose of all medications that are not picked up at the end of the school year.

Medical Forms

• Allergy and Anaphylaxis Action Plan
• Asthma Action Plan
• Physical Form (Español)
• Dental Exam (Español)
• Dental Exam Waiver (Español)
• Diabetes Medical Management Plan
• Eye Exam Form
• Eye Exam Waiver
• Illinois Certificate of Religious Exemption Form
• Medication Authorization Form (Español)
• Seizure Action Plan
• IHSA Sports Physical (Pre-participation) Form (Español)
  • *Cannot be used for 9th grade or transfer student school physicals.

Submitting Forms

Once completed, physical forms, dental forms, proof of immunizations, health care plans, or additional medical information can be submitted in any of the following ways:

School	Email	Fax	Dropped off at school
Conant High School	CHSnurse@d211.org	847.755.3861	700 E Cougar Trail, Hoffman Estates, IL 60169
Fremd High School	FHSnurse@d211.org	847.755.2861	1000 S Quentin Road, Palatine, IL 60067
Higgins Education Center	CNTRnurse@d211.org	847.285.3284	1030 W Higgins Road, Hoffman Estates, IL 60169
Hoffman Estates High School	HEHSnurse@d211.org	847.755.5861	1100 W Higgins Road, Hoffman Estates, IL 60169
North Campus	NCAMnurse@d211.org	847.285.3284	335 E Illinois Ave, Palatine, IL 60067
Palatine High School	PHSnurse@d211.org	847.755.1861	1111 N Rohlwing Road, Palatine, IL 60074
Schaumburg High School	SHSnurse@d211.org	847.755.4861	1100 W Schaumburg Road, Schaumburg, IL 60194

School-Based Mental Health Support

All students have access to school-based mental health support through their assigned school counselor as well as a student’s larger student support team which includes counselors, psychologists, and social workers. In addition to supporting students academically, school counselors are available to help students with social situations, family trouble, peer conflict, and with processing their emotions. School social workers and psychologists are also available to see students for individual and group counseling as well as to link students and families to school and community supports.

For non-emergency mental health concerns in need of school-based support, please reach out to your child’s school counselor.

Suicide Prevention

Suicide is complex with psychological, social, biological, cultural and environmental factors involved. If you or someone close to you is facing challenges in these areas, we encourage you to seek assistance. We want people who are despairing and thinking about suicide to know that there is help available. All you need to do is to ask for help.

If you are facing an immediate emergency call 911.

For non-emergencies, these resources may be helpful:

Concussions

A student’s best chance of full recovery from a concussion involves two critical components: cognitive and physical rest. Continued research has shown cognitive rest to be essential in the quick resolution of concussion symptoms. Cognitive stimulation includes: driving, playing video games, computer use, text messaging, cell phone use, loud and/or bright environments, watching television, reading, and studying. These stimuli must be limited or avoided during recovery. Physical activities that increase symptoms should be avoided. Physical activity such as physical education, athletics and strength or cardiovascular conditioning should be avoided or should be limited and monitored by a trainer when symptoms are present.

Concussion care protocol (Español)

Please contact the nurse’s office if your child has a concussion.

Clinic Locations

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Frequently Asked Questions

If your student is going home sick:

• The student must go to the nurse’s office.
• Health services will call the parent/guardian to confirm the pick up time and destination.
• If your student drove to school, a school representative will need approval from a parent/guardian that you give your student permission to drive home sick.

If your student has a doctor's note:

• Please give a copy of all physician notes to the nurse’s office and they will assist in distributing to the appropriate staff.

If your student arrives to school on crutches:

• Please provide a note from your physician to the nurse’s office, which will be processed and distributed to the appropriate staff.
• An elevator pass and extra time between classes may be provided to assist the student throughout the school day.
• If additional resources are needed, please contact either nurse’s office.

If your student has a fever (temperature of 100 degrees or more):

• Your student must be fever-free for 24 hours without the assistance of a fever-reducing medication, such as Advil, Tylenol, etc. before he/she can return to school.
• If your student is found to have a fever while at school, they must be picked up immediately.

If your student is experiencing flu-like symptoms:

• The CDC recommends that you stay home for at least 24 hours after your fever is gone except to obtain medical care. Your fever should be gone for 24 hours without the use of a fever-reducing medicine.
• Additional details about influenza and vaccinations can be found on the CDC website.
• Visit our resources tab on the Heath Services page for health clinic information.

If your student requires medication while at school:

• Visit our medications tab on the Heath Services page for guidelines for administration of medication.
• No student can carry over the counter medications.

Understanding Type 1 Diabetes for Parents and Guardians:

• Type 1 diabetes is a chronic condition in which the body does not produce insulin, a hormone that helps change sugar (glucose) from food into energy.
• Illinois State Board of Education, in coordination with the Illinois Department of Public Health, developed materials for the parents and guardians of students on Understanding Type 1 Diabetes for Parents and Guardians.

Vision and hearing screenings:

• Vision and hearing screenings are completed according to state guidelines and school policy. Vision and hearing screenings are provided annually to students with an Individualized Education Plan (IEP).
• Students transferring into Illinois for the first-time MUST have a vision exam completed by a physician.
• If a student fails either screening, parents/guardians will be notified and appropriate referrals will be made.

Student Accident Insurance:

• Please reference our Student Accident Insurance page for more information.

Home Hospital Instruction:

• Home/hospital services are provided to a student when a physician licensed to practice medicine in all of its branches, a licensed physician assistant (PA), or a licensed Advanced Practice Registered Nurse (APRN) determines that the student will, or is anticipated to be, absent from school for a minimum of 10 days during the school year due to a medical condition.
• Medical Certification for Home/Hospital Instruction (ISBE Form 34-58)This form is to be retained on file in the local school district after completion by a physician licensed to practice medicine in all its branches, APRN or PA.
• Home-Hospital Instruction FAQ
• Home-Hospital Instruction FAQ (Español)

Teen Pregnancy:

• Township High School District 211 is committed to eliminating barriers to the education of pregnant students. Pregnant students are encouraged to continue their education and are eligible for homebound instruction. Contact the school nurse with any questions.

Other:

• Students need a pass from class to come to the nurse’s office, unless it is an emergency or if the student is going home sick. If it is a passing period, then the student must get a pass from the next class, so the teacher is aware of the student’s attendance.

In the case of an emergency in the classroom: the teacher will press the emergency call button and a nurse will respond.

Please call the nurse’s office with any additional questions or concerns.