Physical Exam & Immunizations

The Illinois School Code Section 27 – 8.1 contains all of the documentation for the physical exam and immunization requirements for school. Click Here

General Information on Completing of the Physical Form

Timetable for Physical Exams:

A physical examination is required for entry into preschool, kindergarten, sixth, and ninth grades. The exam must be completed within one year of entering school at the required grade (Example: for the school year 2017-18, the physical must be dated after September 1, 2016).

Click here for the Administrative Code that explains the timing of the exam:

Who can complete the physical?

The physical can be performed by a physician, physician assistant, or advanced practice nurse as defined in this link: Link

Where can I get the form?

The physical form can be obtained from this link: Link

Date of compliance

The physical exam and proof of immunization must be submitted by October 15th, or an earlier date of the school year determined by the school district. If the district establishes an earlier compliance date, the district must give notice of the requirement 60 days prior to the established date. Link 27 – 8.1 (5)

Immunizations

The immunization portion of the physical exam can be completed and signed by a health care provider (physician, child care or school health professional, or health official).

Immunizations for School Year 2017-18. Link

HIB Vaccine – The state of Illinois refers to the ACIP vaccine recommendations for HIB. The following link provides detailed information on the types of HIB vaccines and the dose schedule that provides compliance with the vaccine. cdc.gov

Alternative Proof of Immunity

A child does not have to receive a vaccine if they have had the disease that the vaccine protects against. However, certain rules apply. Link

Measles – proof of prior measles disease must be confirmed with date of illness signed by a physician or laboratory evidence of measles immunity. A diagnosis of measles disease made on or after July 1, 2002 must be confirmed by laboratory evidence.

Mumps – must be verified with date of illness signed by a physician or laboratory evidence of immunity.

Rubella – must be verified with laboratory evidence.

Varicella – must be verified with date of illness signed by physician, or a healthcare provider’s interpretation that a parent’s description of varicella disease history is indicative of past infection, or laboratory evidence of immunity.

Hepatitis B – must be verified with laboratory evidence.

Health History Portion of the form

This area of the form is required to be completed and signed by the parent or guardian. It is rarely signed before the parent turns in the form to school, so it is the responsibility of the school nurse to get it signed after it is turned in. See section “e” of this link.

Physical Examination Requirements

The following contains the information found in Section 665.150 of the administrative code regarding the other areas of the physical exam form.

Height, weight, BMI, and BP

To be completed by the health care provider. The BMI can be calculated by the school nurse if not complete. See section “b” of the link above.

Diabetes Screening

This area is required to be completed. A child is considered to be at risk for developing diabetes if the BMI is above 85% and any two of the risk factors are checked on the form.
Section 665.700
Section 665.710

Lead Risk Questionnaire

School Code: Sections 6.2 and 7.1
Lead screening questionnaire and instructions: Childhood Lead Risk Assessment Questionnaire 

Lead screening is a required part of the health examination for children age six years or younger prior to admission to kindergarten or first grade. There is a portion of the Physical Exam that is to be completed to document this requirement. If the lead assessment portion of the physical form is incomplete, it can be completed by the school nurse. Please follow the directions of the lead screening questionnaire. If all questions are answered “no,” then the child is not considered to be at risk and does not need a blood lead test. If any question is answered “yes,” the child needs to be referred back to the physician to have a lead blood test performed. The results of the lead test must be documented on the form. A parent may claim a religious objection to this requirement.

TB Skin or Blood Test

According to the Certificate of Child Health Examination form: TB skin test or blood test is recommended only for children in high risk groups including children immunosuppressed due to HIV infection or other conditions, frequent travel to or born in high prevalence countries or those exposed to adults in high risk categories (see CDC guidelines).

The Illinois School Code indicates that TB skin test screening is required if the child resides in an area designated by the Department of Public Health as having a high incidence of tuberculosis. 27 – 8.1 (1)

Lab Tests

Section 665.150
Hemoglobin or Hematocrit, Urinalysis, and Sickle Cell testing are strongly recommended but are not a required part of the physical form completion.

System Review is a required part of the Physical Exam & Imm..

Needs/Modifications, Special Instructions, Mental Health/Other, Emergency Action, Physical Education, and Interscholastic Sports: These areas are not required to be completed but are available if the physician would like to complete them.

Signature of health care provider (physician, advanced practice nurse, or physician assistant) is required. Section 665.130

Compliance with Physical and Immunizations

A student is considered to be in compliance when they have submitted the appropriate documentation for the physical and immunizations required for their grade. Section 665.270

Students who are not compliant with physical or immunizations by October 15th of the school year are subject to exclusion from school until the appropriate documentation has been submitted. Illinois School Code. 

Acceptable documentation includes:

A completed physical form with documentation of the required immunizations.

A note from the physician indicating a scheduled appointment for the missing requirements. If the appropriate documentation is not submitted after the date indicated on the physician note, the student is considered to be noncompliant and is subject to exclusion from school.