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Health Services

A trained and caring health office staff provides quality care to District 31 students. The District employs registered nurses who are available to provide needed first aid, address student health issues, and support student health plans. Have questions about health information at your child's school, or need assistance specific to your child? The school nurse is there for you!

Medical Health Forms

State of Illinois medical forms are required to be completed, by licensed healthcare provider and parent, and returned to the Health Office, prior to the beginning of the school year. Please submit these forms as soon as possible in order to assist with processing the information and medical forms within a timely manner.

Health Requirements

Families must provide health information to the District at the following times:

 

Health Exam
Due by 1st day of school

Dental Exam
Due by  May 15

Eye Exam
Due by Oct. 14

Middle School Athletic Physical
(athletes only)

School Athletic Participation Permission & Concussion Information
(athletes only)

PreK X        
K
X
X
X
Grade 2
X
Grade 6
X
X
X*
X
Grade 7
X
X
Grade 8
X
X
New Illinois Student
X
X
X
X
(if applicable)
X
(if applicable)

Prescription Drugs/ Medication

When a student’s licensed healthcare provider and parent/guardian believe that it is necessary for the student to take medication (prescription or over the counter) during school hours or school related activities, the Medical Authorization form needs to be completed and signed yearly by both the physician and parent/guardian. The parent/guardian and student must follow District #31 procedures for the administration of medication. No student will receive prescription or nonprescription medication, including Tylenol or Motrin, until the school has received a completed medication form. All medications must be brought to school by an adult. Prescription medications must be in originally labeled pharmacy containers. Over the counter medication must be in an unopened package/container.

Asthma 

All students with an Asthma diagnosis must have an, “Asthma Action Plan”, completed and signed yearly by a licensed healthcare provider and parent/guardian. There is no need for a separate medication form for the inhaler/medication when this form is used. Medication must be brought to school by an adult and must be in the originally labeled pharmacy container.

Food Allergies

All students that require Epinephrine (EpiPen, Auvi-Q) for a possible food allergy emergency, must have an, “Allergy Emergency Action Plan and Treatment Authorization”, completed and signed yearly by a licensed healthcare provider and parent/guardian. There is no need for a separate medication form for the antihistamine or Epinephrine when this form is used. This plan also requests a recent picture of your child in the upper right corner. Medication(s) must be brought to school by an adult and must be in the originally labeled pharmacy container.

Undesignated Epipen

The health office has an undesignated EpiPen available for use in case of a suspected anaphylactic reaction. As permitted by law, the EpiPen may be administered to a student exhibiting signs of anaphylaxis by staff trained to recognize the signs and symptoms of a severe allergic reaction. When the lawfully prescribed medication is so administered, parents/guardians waive any claims they might have against the District, its employees, and agents arising out of the administration of the said medicine. In addition, parents/guardians agree to hold harmless and indemnify the District, its employees, and agents, either jointly or severally, from and against any and all claims, damages, caused by actions or injuries incurred or resulting from the administration or attempts of administration of said medication. *If you do not want your child to have epinephrine administered under any circumstances, you must submit a written request to the school, and the nurse and trained personnel will be informed.

Physical Education Exemptions

A student may be exempt from some or all of physical activities when the appropriate reasons/excuses are submitted to the school by parents/guardians (1-3 days) or by a licensed healthcare provider under the Medical Practice Act. If a student needs to be exempt from Physical Education or recess for more than three (3) days, a medical note is required.

From time to time, students may need to use a piece of medical or adaptive equipment (such as a brace or protective eyewear) in order to participate in Physical Education classes. A student must have a note from a physician indicating the type of equipment that the student requires, the duration for which the equipment is to be worn, as well as any restrictions on movement or activity that the injury equipment requires. Once the note is on file, students who do not have, or choose not to wear equipment will not be permitted to participate in the physical education class. Students who do not have a doctor’s note on file will not be permitted to wear any equipment beyond that which is worn by the rest of the class or as required for the class activity. 

Contact Your School NurseField Middle School
Eva Sahyouni, RN 
Certified School Nurse
(847) 313-4454 
esahyouni@district31.net

Winkelman Elementary School
Jeanne Gilligan, RN 
(847) 832-2205 
jgilligan@district31.net

Medical FormsPhysical Exam & Immunization Record 
Complete top section of front page (Student’s name, birth date, grade, address, etc.) and top section of page #2 (Student’s name, etc. and entire* Health History with parent signature/date)
State of Illinois Certificate of Child Health Examination - English
State of Illinois Certificate of Child Health Examination - Spanish

Dental Exam
Complete top of section (Student’s name, birth date, grade, address etc.)
State of IL Dental Exam Form
Dental Exam Waiver Form


Eye Exam
Complete top section of front page (Student’s name, birth date, grade, address, etc.)
Middle section of page #2 (Consent signature/date)
State of IL Eye Exam Form/Report
State of IL Eye Exam Waiver Form


Prescription Drugs/ Medication
Complete top section page #1 (Student information)
Bottom of page #2 (Signature, date, phone #)
Medication Authorization Form

Asthma 
Complete top of form (Student’s name, date of birth, grade) and bottom of page (Signature and date)
Asthma Action Plan Form

Food Allergies
Complete top of page (Student info)
Bottom of page (contacts with phone numbers and signature/date)
Food Allergy Emergency Action Plan and Treatment Authorization

In order to further understand your student’s food allergy, District #31 requests that a parent/guardian fill out a Family Allergy Health History questionnaire yearly to be kept on file and returned with the Food Allergy Action Plan. This is a parent/guardian form only.
Family Allergy Health History Form

Medical Form for Home/ Hospital Instruction
Complete the form below if a licensed medical physician determines a student will be out of school for a minimum of 10 days for a medical condition. 
Medical Form for Home/Hospital Instruction