Health Requirements, Physical Exams, and Immunizations

The School Code of Illinois and Sycamore Community School District 427 Board of Education Policy requires students must meet the following conditions for going into Kindergarten, sixth, ninth, and twelfth grades and for any student attending an Illinois school for the first time. Students will be excluded from school as of October 1 of each year, if the required forms are not completed and on file in the Nurse Office.

Health Requirements for Kindergarten, sixth, ninth grade and New -to-Illinois Students

  1. A completed physical examination on the Certificate of Child Health Examination form signed by a licensed physician or osteopath and dated no earlier than one year prior to the first day of school is required. A sports physical does not meet the requirements and is insufficient. However, the School Physical Examination form can count towards the sports physical exam requirement. )
  2. Transfer students from out-of-state must provide a health form that is comparable to the state of Illinois requirements and is acceptable if the exam was done within one year of entering an Illinois school. If not, the above physical exam is required within 30 days of enrollment. For students entering from out-of-country, an updated physical examination form must be completed and on file before they can attend school.
  3. Parents are to sign and complete the top medical history section of the physical form.
  4. A statement from a physician or health care provider stating that the student has been screened for lead poisoning is required (kindergarten students only).
  5. TB Screening is recommended but not required at this time.
  6. A complete immunization record signed by the child’s health provider including: (see chart below)
    • DPT series with last immunization after the fourth birthday
    • Tdap vaccination for students over 11 years old and entering sixth through twelfth grade
    • Polio series with last immunization after the fourth birthday
    • Hepatitis B series (3)
    • Measles, Mumps and Rubella  (2)
    • Meningitis for sixth grade and twelfth grade
    • Varicella (2)
    • For Early Childhood Students: must also meet the HIb vaccine requirements

Dental Requirements for Kindergarten, Sixth Grade, and New-to-Illinois Students


Dental Examination or Dental waiver

A complete Dental examination signed and dated by a dentist is due by May 15 of the current school year.

A Dental Waiver may be submitted in lieu of the examination if your child is in the free and reduced lunch program and is not covered by AllKids/Medicaid, is ineligible for Dental insurance or you are unable to find a provider who accepts AllKids/Medicaid and/or there are no low-cost dental clinics in the community that will see your child.

Vision Requirements for Kindergarten and New-to-Illinois Students


Vision Examination or Vision Waiver

A completed Vision examination signed and dated by an Optometrist or medical doctor who performs eye examinations is due by October 15 of the current school year. A completed Vision Waiver may be submitted if your child is enrolled in AllKids/Medicaid and you are unable to find a provider, you do not have vision insurance including AllKids/Medicaid and there are no low-cost clinics in the community or any undue burden or lack of access to a provider of eye examinations.

Twelfth Grade State of Illinois Requirement

All incoming and transfer students entering GRADE 12 will be required to show proof of receiving two doses of the meningococcal conjugate vaccine. The first dose shall have been received on or after the 11th birthday, and the second dose shall have been received on or after the 16th birthday, at least eight weeks after the first dose. If the first dose is administered when the child is 16 years of age or older, only one dose is required.

Certificate of Religious Exemption

Parents or legal guardians who object on religious grounds to complete any required immunizations or examinations must complete a Certificate of Religious Exemption form, which must also be signed by the physician, advanced practice nurse or physician assistant responsible for performing the student examination. The healthcare provider signature on this new form attests to informing the parent or legal guardian of the benefits of immunization and the health risks of not vaccinating the student. Per the State Of Illinois, the certificate requires the parent or guardian signature to attest to understanding that their child may be excluded from school in the case of a vaccine-preventable disease outbreak or exposure.

Overall Requirements

GradeSchool PhysicalDental ExamEye ExamTetanus, Diphtheria, pertussis (DPT,DTap) SeriesMMR (2 doses)Polio SeriesVaricella (2 doses)Hepatits B Vaccine (Series of 3)Meningoc occal (MCV)TDap Vaccine

*All students in twelfth grade will need to show proof of receiving two doses unless the first dose was administered after 16 years of age. In this case, only one dose after 16 years of age is required.