Please keep a copy of all completed health forms for your own records.

• Illinois Certificate of Child Health Examination  – To be completed and signed by your child’s doctor. Parent must also complete top of page 1 and 2, and sign page 2. Required for all new students and students entering grades K, 6, 7 and 8. Due to the new requirement for Tdap (Tetanus/Diptheria/Acellular Pertussis) vaccinations, students in grades 6, 7, 8 and through high school must show proof of this immunization.
• Illinois Proof of Dental Exam  [Español] – To be completed and signed by your child’s dentist. Required for students entering grades K, 2 and 6.
• Illinois Dental Exam Waiver  [Español]
• Illinois Vision Exam Report [and Waiver] – To be completed and signed by your child’s optometrist or ophthalmologist. Required for students entering Grades K (or 1) and for all students transferring in from out of state.
• IESA Sports Physical Form – Required for all students to be allowed to participate in interscholastic athletics provided through our middle schools.
• Medication Authorization Form & Student Agreement – Required for all prescription and over-the-counter medications taken or carried at school.
• Childhood Lead Risk Assessment Form  [Español] – Required for children through age 6.
• More information regarding health management plans, physicals, and immunizations is available on the Hawthorn Health Services web pages.

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