Required Health Information and Forms
*Access forms on the right side of this page under health forms. Print and complete each form. Submit completed forms to the school nurse.
A Student Emergency/Medical Information form must be completed online by the first day of school. This is part of the online registration process completed in the PowerSchool Parent Portal.
A State of Illinois Certificate of Child Health Examination form (Physical Exam Form) must be completed by a physician and parent for students entering KINDERGARTEN and SIXTH GRADE and STUDENTS TRANSFERING FROM OUT OF STATE OR OUT OF THE COUNTRY.
An Illinois Department of Public Health Proof of Dental Examination (Dental Form) form must be completed for students entering KINDERGARTEN, SECOND and SIXTH GRADES.
A State of Illinois Eye Examination Report (Eye Exam Form) must be completed for any student entering the Illinois school system for the first time (out-of-state transfer or home schooled).
A School Medication Authorization (Medicine Form) must be completed by a physician and a parent for prescription and over-the-counter medication to be administered at school. Students are not permitted to carry medication on school premises. The exception to this rule is students may carry and administer an inhaler or an Epi-Pen with physician and parent written authorization on the medication form.
A Food Allergy Action Plan NEW (Food Allergy Form) form must be completed by a physician and parent for any student with a severe allergy which requires the administration of an Epi- Pen.
A Marie Murphy School Athletic Permit (Marie Murphy Athletic Permit Form) signed by a physician and a parent must be on file in the office of the school nurse before a student will be permitted to participate in interscholastic sports. Student accident insurance is provided by the district at no cost to the student’s family. Information regarding accident insurance is included in a summer mailing.
Vision and Hearing Screening
Annual vision screening is done on all preschool, K, 2nd, and 8th grade students. Annual hearing screening is done on all preschool, K, 1st, and 3rd grade students. If you do not want to have your child participate in these programs, please notify the school nurse.
School Nurses
Please visit our nurses’ webpages for more important health information!
Joanne Banks- Marie Murphy School (847) 251-3617
Shari Theer- Avoca West School (847) 724-6800
