Medical Forms

In order to enroll in school at East Prairie, there are certain medical forms that need to be completed by parents and turned into the school office. Please see the descriptions of these forms below and if needed, they  can be downloaded and printed by clicking on the link provided.

In addition to being in compliance relative to immunizations, children must receive physical examinations prior to entering Illinois schools for the first time, prior to the date of entering preschool, kindergarten, prior to entering sixth grade, and prior to entering ninth grade. Children also need a physical examination yearly if playing sports. Parents – please remember to fill out the health history portion of the form and sign it.  It is considered incomplete if this is not filled out and will be returned.  Any student who does not comply with immunization and physical examination requirements will be excluded on the first day of school.
Click here to Download Form

If your child requires any medication to be taken at school, please download the linked file and have it filled out by your childs' doctor.

Click here to download form

All Illinois children in kindergarten, second and sixth grades are required to have a dental examination by a dentist.  Each child shall present proof of examination by May 15th of the school year.

Click here to Download form

All children enrolling in kindergarten are required to have an eye examination.  Each child shall present proof of examination by an optometrist or physician who provides complete eye examinations by October 15th of the year the child is enrolled in school.
Click to Download Eye Examination Form
Click to Download Eye Exam Waiver

All incoming 9th grade students must have a physical examination and up-to-date immunizations on file in the Nurses' Office in order to attend Niles North High School.  Niles Township High School District 219 has a policy of first day exclusion. This means that students who do not have a current physical exam and immunization records on file will be excluded from school until such requirement is met. 
Click To Download Form

In addition to being in compliance relative to immunizations, East Prairie School must post the latest ISBE Data regarding the numbers of children that have be immunized.
Click Here to Download Form.

For More information, please contact the School Nurse at:  

East Prairie School
847-673-1141 Ext. 1102