Health Office » Health Requirements and Forms

Health Requirements and Forms

Physical Exam and Health Requirements:
Illinois state law requires each student to have a physical examination performed by a licensed health care provider (MD, DO, APN or PA).  State law also requires evidence of state-required vaccinations as outlined here. The School Code Section 665.120 of Illinois provides for an exclusion from school for students not in compliance with health requirements.  Students may not attend classes at Riverside Brookfield High School until the health examination and immunization records are on file and in compliance with the regulations.
Medication Authorization Form:
Students may not possess or consume medications, including over-the-counter medications, without the express written orders of a physician. Designated faculty and staff members will administer all medications to students during school hours and during school-sponsored activities. Parents should make every effort to give prescribed doses of medication at home. Medication will only be administered when it is necessary to maintain the students in school. A new Medication Authorization form must be submitted to the school at the beginning of EACH school year. Click here to review our Medication Policy
Proof of Dental Examination:
All Illinois children in Grade 9 or new transfer students from out of state are required to have an oral health examination: DUE BY MAY 15 OF THE CURRENT SCHOOL YEAR
  • This is required for all public, private and parochial schools
  • Examinations must be performed by a licensed dentist, and he/she must sign the Proof of Dental School Examination form (attached below) 
  • Each child is required to present proof of examination by a dentist prior to May 15 of the school year
  • School dental examinations must have been completed within the 18 months prior to the May 15 deadline
Vision and Hearing Screening Requirements:
Vision and Hearing screenings will be done, as state mandated, for all Special Education students, all students transferring into Riverside Brookfield High School for the first time and all teacher referrals. Vision screening is not a substitute for a complete eye and vision evaluation by an eye doctor.  Students are not required to undergo vision screening if an optometrist or ophthalmologist has completed and signed a report form indicating that an examination has been administered within the last 12 months and that evaluation is on file at the school.  This notice is not permission to test, and permission is not required to be returned.  Parents may opt out with a written notice to the school nurse 
Illinois Certificate of Religious Exemption Form:
Parents or guardians requesting a religious exemption from immunizations must submit the Illinois Certificate of Religious Exemption Form. This form is to be signed by the child's physician as well as the parent. This is required in lieu of vaccination record to begin classes at RBHS.
A sports physical does not serve as a school physical, though a school physical may serve as a sports physical. All sports physicals should be turned in directly to the athletics office.
Immunization Data 2023-2024
Public Act 097-0910 requires that on or before December 1st of each year, every public school district and registered non-public school shall make publicly available the immunization data they are required to submit to the State Board of Education by November 15th.