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Health Forms and Emergency Action Plans

Health requirements for Mattoon Community Unit School District 2

Health requirements for Mattoon Community Unit School District 2

It’s not too early to make sure your child is up-to-date with their health exams and immunizations for the upcoming school year. Mattoon school district is required by Illinois Law to monitor and report the status of health examination and immunization compliance. 

 All children in Illinois shall have a health examination as follows:  within one year prior to entering kindergarten or the first grade of any public, private, or parochial elementary school; upon entering the sixth and ninth grade of any public, private, or parochial school;  prior to entrance into any public, private, or parochial nursery school.   ILCS 5/27-8.1, chapter 122, par 27-8.1, (1)

Mattoon School District request physical examinations and immunizations be submitted by the registration date determined by the school district.  However if no physical exam or required immunization are not submitted please note:  “If a child does not comply by October 15, then the school authority shall exclude that child from school until such time as the child presents proof of having the health examination as required and presents proof of having received those required immunizations.”  ILCS 5/27-8.1, chapter 122, par 27-8.1, (5)

Please contact your child’s school nurse for more information or guidance on the following requirements.

Immunization abbreviations spelled out:

DPT, DTP, DTaP = Diptheria, Pertussis, Tetanus

IPV = Inactivated polio vaccine

MMR = Measles, Rubella, Mumps

HepA = Hepatitis A

HepB = Hepatitis B

HPV = Human Papillomavirus Vaccine

HIB = Haemophilus Influenzae Type B

VAR = Varicella (chicken pox)

Tdap = Tetanus, Diptheria, acellular pertussis (pertussis = whooping cough)

PCV = Invasive Pneumococcal Disease

MCV4C = Meningococcal

 

Mattoon students grade specific health and immunization requirements:

PRE-SCHOOL

Physical exam

3 doses DPT by 1 year of age. One additional booster dose by 2nd birthday

2 doses of Polio by 1 year of age.  One additional dose by 2nd birthday

1 dose MMR after 1st birthday

3 Hepatitis B immunizations, the 3rd dose must have been administered on or after 6 months of age (168 days)

1 Varicella immunization after 1st birthday

HIB (haemophilus influenza type B) series for children 24-59 months.  Children without series must have one dose after 15 months of age.

PCV (Pneumococcal) series for children 24-59 months.  Children without series must have one dose after 24 months of age.

 

KINDERGARTEN

Physical Exam

Eye Exam – There is a waiver for the Eye Exam

Dental Exam – The dental exam must have been completed by a dentist within 18 months prior to May 15th deadline.  There is a waiver for the dental examination.  Sarah Bush Lincoln Dental Services does provide this dental examination at school free of charge to all students. Watch for the permission paper at registration. 

4 or more doses of DPT with the 4th dose received on or after the 4th birthday

4 doses of Polio with the last dose qualifying as a booster and received on or after the 4th birthday

2 doses of MMR, first dose on or after 1st birthday, 2nd dose no less than 28 days later

2 doses of Varicella, first dose on or after 1st birthday, 2nd dose no less than 28 days later

 

1ST GRADE

All above immunizations required in previous grade

 

2nd GRADE

All above immunizations required in previous grade

2ND graders are required to have Dental Exam – the dental exam must have been completed by a dentist within 18 months prior to May 15th deadline.  There is a waiver for the dental examination.  Sarah Bush Lincoln Dental Services does provide this dental examination at school free of charge to all students. Watch for the permission paper at registration. 

3rd 4th 5th GRADE

All above immunizations required in previous grade.

There are no requirements for physical exam for these grades.  However your child may participate in the Sarah Bush Lincoln Dental Exam program with a signed permission.

 

 6th GRADE

Physical Exam

Dental Exam, the dental exam must have been completed by a dentist within 18 months prior to May 15th deadline.  There is a waiver for the dental examination.  Sarah Bush Lincoln Dental Services does provide this dental examination at school free of charge to all students. Watch for the permission paper at registration. 

All above immunizations required in previous grade plus:

Tdap booster for students aged 11-12

Hep B – 3 doses of hepatitis B

MCV4 – Meningococcal conjugate vaccine given on or after 11 birthday

 

7th 8th GRADE

There are no requirements for physical exam for these grades.  However your child may participate in the Sarah Bush Lincoln Dental Exam program with a signed permission.

Tdap if not received in 6th grade due to age

MCV4 if not received in 6th grade due to age

 

9TH GRADE

Physical Exam

All above immunizations required in previous grade

Dental Exam, the dental exam must have been completed by a dentist within 18 months prior to May 15th deadline.  There is a waiver for the dental examination.  Sarah Bush Lincoln Dental Services does provide this dental examination at school free of charge to all students. Watch for the permission paper at registration. 

10th 11th GRADE

All above immunizations required in previous grade

 

12th GRADE

All above immunizations required in previous grade plus:

MCV4 -  2nd dose upon 12th grade entry received on or after the 16th birthday

 

MENINGITIS VACCINE NOTICE

Meningitis is a serious and possibly fatal bacterial infection that most often causes severe swelling of the tissue around the brain and spinal cord (meningitis) or a serious blood infection (meningococcemia). To protect your child from this disease the Illinois Department of Public Health (IDPH) requires that:

Any child entering the 6th grade shall show proof of having received one dose of meningococcal conjugate vaccine on or after the 11th birthday. The children entering 6th grade will receive this notice with their physical examination form.

Any child entering the 12th grade shall show proof of having received two doses of meningococcal conjugate vaccine prior to entering the 12th grade. The first dose shall have been received on or after the 11th birthday, and second dose shall have been received on or after the 16th birthday. If the first dose is administered when the child is 16 years of age or older, only one dose is required.

You child will need the meningitis vaccine by start of school in August. The school nurse will ask for proof of receiving the immunization at registration.

Health Forms

Certificate of Child Health Exam and Immunization

Preschool Requirements Page 1

Preschool Requirements Page 2

Kindergarten Requirements Page 1

Kindergarten Requirements Page 2

Kindergarten, Second and Sixth grade dental form

SBLHC Dental Program

SBLHC Dental Form

Proof of Dental Exam Form

Sixth Grade Physical Requirements

Ninth Grade Physical Requirements

Exam Form Updated

Registration Health Record

School Medication Authorization Form

Extracurricular Medical Protocal and Procedures

 

 

 

Hearing and Vision Testing Schedule 2019-2020

Hearing Testing Schedule 2019-2020

Vision Testing Schedule 2019-2020

 

Emergency Action Plans And Forms

Dear families:

    At school we strive to protect the wellbeing of our students, especially those with special health problems.  The Emergency Action Plans listed below will enable school personnel to better provide for your child's wellbeing.

    Because of this commitment, it is important that parents or guardians share certain confidential information about the student's health problem.  This information will be used to plan for the care and management of the student's health condition.  It will be shared with those members of the professional school staff who have direct responsibility for the student when in school or participating in school activities.  In addition, we ask you to help us update the plan on an annual basis.

    If your child has a chronic health problem or a health condition that may create a need for emergency or supportive care during the school day, please complete the appropriate Action Plan and return it to the health office.  The school nurse is available to assist you in completing the form or answering any questions that you may have concerning the use of the information requested.

    It is important that you notify the school nurse during the school year of any changes in your child's health status, medications, or treatments so that the student's emergency action plan can be adjusted.  Parent-school communication is vital to the success of the program and the safety of our students.

    Thank you for assisting us in providing a successful school experience for all students with special needs or chronic health problems.

Mattoon School District Nurses

 

Asthma Medication Inhaler

Asthma Medication Nebulizer

Asthma Action Plan Letter to Families

Action Plan Consent Form

IDPH Asthma Action Plan

Medical Action Plan

Allergy and Anaphylaxis Emergency Plan 

Anxiety Action Plan

Cardiac Care Plan

Severe Bee Sting Allergy without EpiPen

Student Medical Information

Seizure (Parent Questionnaire)

Seizure Action Plan

Authorization to Provide Diabetes Care

Diabetes Medical Management Plan

Action Plan for High Blood Sugar

Action Plan for Low Blood Sugar

 

 

 

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Mattoon Community Unit School District 21701 Charleston AvenueMattoon, IL  61938

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