Below are some of the most commonly requested health forms as well as health information on a variety of topics. Click the links to view and download PDFs. Should you have any questions, contact your school nurse. 

To skip directly to a certain section, click the links below:

Asthma
Certificate of Child's Health Exam
Diabetes
Food Allergies
Homebound/Hospitalizations
ISBE Student Health Data
Immunizations
Insurance
Low-Cost Clinics
School Medication Authorization Form
Seizures

 

Asthma

AcrobatPDF36x36 Asthma Action Plan

AcrobatPDF36x36 Asthma Inhaler/Epipen Self-Administration Request

 

Certificate of Child's Health Exam

AcrobatPDF36x36 Certificate of Child's Health Exam (English)

 

Diabetes

AcrobatPDF36x36 Medical Management Plan

 

Food Allergies 

AcrobatPDF36x36 Allergy Care Plan

 

Homebound/Hospitalization

Please notify the school nurse and/or counselor when your child has been hospitalized.  Most hospitals have tutors available but it remains the parents’ responsibility to coordinate between the school and hospital.  A doctor’s note is required allowing the student’s return to school.
 
For further information regarding Homebound/Hospital Instruction refer to the Township High School District 214 Student and Parent Handbook.

 

ISBE Student Health Data — By School 

AcrobatPDF36x36 Buffalo Grove High School AcrobatPDF36x36 Elk Grove High School
AcrobatPDF36x36 John Hersey High School AcrobatPDF36x36 Prospect High School
AcrobatPDF36x36 Rolling Meadows High School AcrobatPDF36x36 Wheeling High School


 

Immunization

AcrobatPDF36x36 Clinics

AcrobatPDF36x36 New Requirements

AcrobatPDF36x36 Religious Exemption Form

 

Immunization Records After Graduation A complete list of the student’s immunizations is available after graduation by contacting the Registrar.  Because this is considered a transcript of the immunizations, the student must sign a form releasing the immunizations records and pay a nominal fee. For further information regarding Procedure to Request a Transcript and/or Immunization Records, refer to the Township High School District 214 Student and Parent Handbook.

 

Insurance

AcrobatPDF36x36 Illinois All Kids application, English

AcrobatPDF36x36 Illinois All Kids application, Spanish

Low-Cost Clinics, By School

AcrobatPDF36x36 Buffalo Grove High School AcrobatPDF36x36 Elk Grove High School
AcrobatPDF36x36 John Hersey High School AcrobatPDF36x36 Prospect High School

AcrobatPDF36x36 Rolling Meadows High School, English

AcrobatPDF36x36 Rolling Meadows High School, Spanish

AcrobatPDF36x36 Wheeling High School, English

AcrobatPDF36x36 Wheeling High School, Spanish


 

Medication/Prescriptions

AcrobatPDF36x36 Request Form

 


Seizures

AcrobatPDF36x36 Seizure Action Plan