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New Lenox School District 122

Medical Forms and Information

Click the blue bars below to browse the medical forms and informational documents.  For additional district medical information and notices, read further down the page.

Click Here for Medical Forms

Asthma Action Plan

Dental Exam Proof

Dental Exam Waiver

Eye Exam Proof

Eye Exam Waiver

Food Allergy Emergency Action Plan

IESA/IHSA Preparticipation Form

Medication Authorization Form

Religious Objection Form

School Physical Form

Student Accident Insurance Posting

Tdap Vaccine Parent Notification

School Health Exam Requirements for State Compliance

 Kindergarten:

  • Physical Exam with immunizations
  • Dental Exam
  • Vision Exam

2nd Grade:

  • Dental Exam

6th Grade:

  • Physical Exam with immunizations
  • Dental Exam

New students who did not attend an Illinois school last year:

  • Physical Exam with immunizations on an ILLINOIS school form
  • Vision Exam

Notice:  One of the required immunizations, Meningococcal vaccine, must be given after the child's 11th birthday. If your child has their physical prior to the 11th birthday, schedule a date after their birthday to obtain the vaccine. They will still be in compliance if the immunization is given after school starts. Please contact your school nurse if you have questions.