In the name of Allah, Most Merciful and Compassionate.

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Health Forms

The Illinois Department of Health school code requires the following student’s health records to be submitted to the school.

Required Student Health Records for New Students:

  • KG – 12th: Physical examination form with complete immunization including Tdap and Meningitis (MCV) 1st Dose for 6th grade, and Meningitis (MCV) 2nd Dose for 12th grade completed in the last ten months.
  • KG – 12th: Dental, Vision, and Hearing examination forms completed in the last ten months for all grade levels.
  • PS – PK: A Physical examination form with complete immunization done in the last ten months is required for PS to PK.

Please note all students with Asthma or Food Allergies must provide an Asthma action plan and Food Allergies action plan signed by their doctor in the last ten months.

For students with religious immunization exemptions, please submit a religious exemption form signed by the doctor in the last ten months.

Required Student Health Records for Returning Students:

  • KG: Physical with complete immunization, Dental, and Vision examination forms done in the last ten months
  • 2nd grade: Dental examination form done in last ten months.
  • 6th grade: Physical with complete immunization Including Tdap and Meningitis (MCV) 1st dose and Dental examination form done in last ten months.
  • 9th grade: Physical with an updated immunization record and Dental examination forms done in the last ten months.
  • 12th grade: Only Meningitis vaccine immunization (MCV) 2ND dose is required.
  • The student with Asthma and Food allergies must provide an Asthma action plan and Food allergies action plan signed by their doctor in the last ten months.
  • The student with a religious immunization exemption requirement must provide an immunization religious exemption form signed by the doctor in the last ten months.

Please submit all required health records by the first day of school .

If you have any questions, please call the school nurse, Asma Khatoon at (630) 941-8800 Ext 1017, Email: akhatoon@ifsvp.org or FAX: 630-941-0114