Freshman Medical Forms
IDPH physical form: http://www.dhs.state.il.us/OneNetLibrary/27897/documents/Forms/IL444-4737.pdf
IDPH dental form: http://www.idph.state.il.us/HealthWellness/oralhlth/DentalExamProof10.pdf
Permission Form To Administer Medication
Student Health Plan - Heart Conditions
Student Health Plan - Seizures
Student Health Plan - Severe Allergies
Freshman Physical: The State of Illinois Certificate of Child Health
(A physical is required for Examiniation is the only form that will be accepted by
ALL Freshman) the State of Illinois. This form includes a physical and immunization record and must be completed and signed by the doctor and parents. Parents please complete the Health History portion of the physical form. A Sports Physical is NOT accepted as a 9th grade physical.
DO NOT GIVE THE PHYSICAL TO A COACH! It must be turned into the School Clinic. If a coach requires a physical before the first day of school, please give a copy to the coach, but DO NOT expect that it will be forwarded to the School Clinic. ALWAYS KEEP A COPY FOR YOURSELF!
Please mail physicals to Carmel Catholic High School, Kathy Hunter, RN, One Carmel Parkway, Mundelein, IL 60060, Before August 1, 2011.
Medications: Students requiring Prescription Medication at school MUST have a Medication Administration form completed by their doctor and parents. This includes inhalers and epi pens needed for emergency treatment.
Over the Counter Medications: An over-the-counter medication form is also available and must be completed by parents for students to take medications as school. Policies regarding medication administration at school are in the Student Handbook.
Students with Chronic Illnesses: Health Plans for students with Chronic Illnesses. These Health Plans assist parents in communicating health needs to the School Nurse and teachers and are highly encouraged. Please complete the form and submit to the school nurse. Any student requiring medication at school must also have a Medication Administration form completed by the doctor and parent.
If you have any questions, please call Mrs. Kathy Hunter, RN at (847) 388-3343.