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Arnold J. Tyler
Elementary School
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Mrs. Wrona
School Nurse - Tyler
kwrona@nlsd122.org

School Nursing Rocks!

Health Forms

llinois School Physical Form  Physical exams are required for students entering preschool, kindergarten, 6th grade, and for students entering an Illinois school for the first time. 

Certificate of Religious Exemption - required for students whose parents claim a religious objection to receiving vaccines. 

Illinois Dental Exam Form Dental exams are required for students in kindergarten, second, and sixth grades

Illinois Eye Exam Form Vision exams are required for students in kindergarten and for students entering an Illinois school for the first time.

Asthma Action Plan This form is required for students with asthma. 

Seizure Action Plan This form is recommended for students with seizure disorder, but a form from your health care provider will also be acceptable. 

Medication Authorization Form This form is required to be completed for administration of medication in school. The use of inhalers for asthma do not require a physician's order but do require the prescription label and written parent permission on the back of the medication authorization form. 

Food Allergy Action Plan The form must be completed by a licensed health care provider and the parent/guardian. It is the parent/guardian responsibility to submit the form and the emergency medication to the school health office prior to the student attending school. 

School District Policies and Procedures

New Lenox School District Procedures

Parent Student Handbook 

When to keep your child home from school  - p. 39

Asthma  - p.40

Food Allergies - p. 40

Epinephrine in School p. 41

P.E. Excuses p. 42

Vision & Hearing Screening p. 42

Communicable Disease Management p. 42

Medication administration - p. 43

Health Exam Requirements - p. 45

Concussions & head injuries - p. 46

When To Keep Your Child Home From School

The School Nurses of New Lenox School District follow the recommended practices and procedures of the Illinois Department of Public Health, which are set forth by the Illinois State Board of Education and the Illinois Nurse Practice Act.

Staying home - A child should stay home for 24 hours after any of the following have occurred:

1. Fever of 100 degrees or above

2. Vomiting or diarrhea