Health Services

Name: Amy King, BSN, RN, CSN
Email:  [email protected] 
Phone:  847-881-9503

Grade Level Medical Requirements

Certificate of Child Health Examination forms are required for incoming kindergarteners and all new students. For information regarding State of Illinois mandated Certificate of Child Health Examination forms, dental, and vision requirements, please click on Health Forms by grade level linked on the right. Please complete the Concussion Information Form requiring parent signatures for all students. Please contact the school nurse if your child has an allergy, asthma action plan, or requires special accommodations.


The parent or legal guardian of a student may object to health examinations, immunizations, vision and hearing screening tests, and dental health examinations for their child on religious grounds. If a religious objection is made, please read and fill out the IL Certificate of Religious Exemptions Form. General philosophical or moral reluctance to allow physical examinations, immunizations, vision and hearing screening, and dental examinations will not provide a sufficient basis for an exception to statutory requirements. The local school authority is responsible for determining whether the written statement constitutes a valid religious objection.

Medical Objection
Any medical objection to an immunization must be:

  1. Made by a physician licensed to practice medicine in all its branches indicating what the medical condition is.
  2. Endorsed and signed by the physician on the Certificate of Child Health Medical Objection Examination form and placed on file in the child's permanent record. Should the condition of the child later permit immunization this requirement will then have to be met.


In the event of an accident, the school nurse will be contacted. If the nurse is not immediately available, the injured student will not be moved until examined by an adult trained in first aid. It will be the school nurse's responsibility to determine, the need for further medical assistance. In the event that additional emergency medical aid is needed, paramedics will be called. If possible, the parent will be consulted prior to this action. A report of accident or injury form will be completed and placed on file with the school nurse. School District 29 has purchased Student Accident Insurance Coverage on each child's behalf.

This program provides student coverage for injuries incurred while participating in school-sponsored and/or supervised activities, including athletics. Aside from the school-sponsored coverage provided by District 29, the program administrator also offers 24-hour unlimited Dental Accident coverage and also 24-hour coverage providing protection during vacations and weekends. Brochures and applications outlining these programs are available in the school office.

Please call or email me if you have any questions or concerns.

Influenza & Vaccinations
Click HERE for information about influenza and vaccinations

Health Forms

Vision Exam Form

Medication Authorization Form

Medical Updates Information Grid

Dental Exam Form

IL Child Health Exam Form (English)

IL Child Health Exam Form (Spanish)

Immunization Requirements and Religious Exemption

Concussion Information Form

Medical Management Plans

Asthma Action Plan 

Diabetes Plan

Food Allergy Plan

Seizure Action Plan

Middlefork Snack List

Approved Snack List (updated 8-29-23)
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