The Certificate of Child Health Examination needs to be completed and signed by a licensed physician, nurse practitioner or physician's assistant. Only the approved State of Illinois Certificate of Child Health Examination form is accepted. The examination must have been completed after August 25, 2021, that is, within the 12 months prior to the first day of school.
The Will County Health Department (815-727-8670) can be contacted for the immunization clinics.
Check the following BEFORE submitting the Certificate of Child Health Examination:
- Health care provider has signed under the completed immunizations section AND on the bottom of the second page
- Height, weight and blood pressure is recorded on the form
- Lead Risk Questionnaire completed for children age six years or younger
Forms for Download
Completed health forms can be emailed to [email protected] or sent by fax to 708-847-7002.
If you have any questions, please contact Kate Lynch-Hale, Health Coordinator at (708) 367-8350.