Illinois Certificate of Child Health Examination Form

State of Illinois law requires proof of a physical examination dated no earlier than one year prior to a student entering grade 9, for all students entering the district for the first time, and for all students entering District 202 from outside the State of Illinois or the United States. Proof of physical exam and immunization dates and records must be submitted on the Child Health Examination Form. Download this form and have it completed, signed, stamped and dated by your child's health care provider.

Illinois Certificate of Child Health Examination Form.pdf, 419.31 KB; (Last Modified on January 4, 2016)