Health Forms and Information - Health Services

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
Dental
Diabetes
Food Allergies
Homebound/Hospitalizations
ISBE Student Health Data
Immunizations
Insurance
Medication/Self-Administration Form
Seizures

Asthma

Asthma Action Plan

Medication/Self-Administration Form

Certificate of Child's Health Exam

Certificate of Child's Health Exam (English)

Dental

Proof of School Dental Examination Form
Proof of School Dental Examination Form (Spanish)

Diabetes

AcrobatPDF36x36 Diabetes Medical Management Plan

Food Allergies

AcrobatPDF36x36 AAP Allergy and Anaphylaxis Emergency Plan

Medication/Self-Administration Form

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 (Submitted to ISBE 11/15/19)

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

Immunization

AcrobatPDF36x36 Clinics

Clinics, Spanish

AcrobatPDF36x36 New Requirements

AcrobatPDF36x36 Religious Exemption Form

Immunization Records Immunization record requests for current students can be obtained by contacting the school's student services department and completing an Immunization Record Request Form. No fees are required for these requests.

Alumni can request immunization records by following the procedures outlined in the following PDF downloads. Click on your school icon to download Alumni Immunization Request Form. Non-enrolled students and alumni must pay a $10 fee for each immunization record requested. For further information regarding Procedure to Request a Transcript and/or Immunization Records, refer to the High School District 214 Student and Parent Handbook.