Important Information About Required Physical Exam Forms

The Certificate of Child Health Examination is the official form that must be used by your child’s physician to document the required physical exams for Pre-K, Kindergarten, and 6th grade students.

What Must Be Completed on the Form:

• All sections must be fully completed by the physician, including the Diabetes Screening
• Lead screening is required for children 6 years of age and under
• Tuberculosis (TB) screening is strongly recommended
• The Health History section must be completed and signed by a parent or guardian

Please ensure the form is complete before submitting it to the health office. Incomplete forms will be returned and may delay your child’s ability to attend school.

Proof of School Dental Examination – State Requirement

In accordance with Illinois state law, all students in Kindergarten, 2nd Grade, and 6th Grade are required to submit proof of a dental examination by May 15th of the current school year.

If proof is not submitted by this deadline, Union Ridge School may withhold your child’s report card until one of the following is provided:

• Proof of a completed dental examination
• Documentation of a scheduled dental exam within 60 days after May 15th
• A dental examination waiver form

While not required, dental exams are strongly encouraged for students entering Pre-K.

Proof of Eye Examination – State Requirement

In accordance with Illinois state law, all students entering Kindergarten or enrolling in an Illinois school for the first time must submit proof of a comprehensive eye examination conducted by an optometrist or a physician who performs eye exams.

The completed exam must be submitted to the school no later than October 15th of the current school year.

If proof of the exam is not submitted by the deadline, Union Ridge School may withhold the student’s report card until one of the following is provided:

• Proof of a completed eye examination
• Documentation of a scheduled eye examination within 60 days after October 15th
• A completed eye examination waiver form

Sports Physicals & Required Forms for Student Athletes

In order for students to participate in any extra-curricular sport at Union Ridge School, the following must be submitted before your child can practice or compete:

1. A sports physical, dated within one year of the start of the sport
2. A completed Consent & Authorization for Emergency Medical Services” form
3. Concussion Acknowledgement & Consent

All three documents are required prior to participation in any tryouts, practices, or games.

Please note that the Illinois Elementary School Association mandates the following:
3.061 No student shall be permitted to compete in a try-out, practice, or game unless such student has filed with the school principal a certificate of physical fitness issued by a licensed physician, physician’s assistant, or nurse practitioner as set forth in the Illinois State Statutes not more than 395 days preceding such tryout, practice, or contest in any athletic activity. 

3.062 No student shall be allowed to participate following disabling illness or injury without a physician's release.

If you have any questions or concerns, please contact the school nurse.