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Welcome to the District 25 Health Services web page. Here you will find all forms needed by parents and students that relate to health.
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Allergy & Wellness
A goal of District 25 is to provide a safe environment for all children. Students with life threatening allergies may require certain safeguards in order to be safe in school.
Protecting students with life-threatening allergies is the shared responsibility of families, schools, and the community. Arlington Heights School District 25 cannot create or ensure an all allergen-free environment. That said, the Allergy Guide below addresses the needs of students with life threatening allergies and when implemented will reduce the risks associated with exposure.
Allergy & Wellness Forms & Guide
District 25's Allergy Resource Guide
Annual Severe Allergy Survey – Parent Info (A)
Annual Severe Allery Survey - Parent Info (A) Spanish
Illinois Food Allergy Emergency Action Plan (B)
EpiPen Self-Administration Form (C)
Lunchroom Table Preference (D)
Annual Physician Statement Requiring Menu Modifications (E)
Media & Movement
We were special presenters for a FARE webinar!
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Asthma Information & Forms
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Dental Forms
All Illinois children in Kindergarten, Grade 2 and Grade 6 are required to have a dental examination.
Each child is required to present proof of examination by a licensed dentist prior to May 15 of the school year.
Dental Forms
Click on the links below to download the necessary dental forms.
Formulario Comprobante del Examen Dental Escolar
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Diabetes Information & Forms
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Head Lice Information & Forms
In an effort to control the spread of head lice, we ask that you carefully inspect your child’s scalp at least once a week. The best way to find head lice is to take your child to a well lit area, use a magnifying glass and a fine-tooth comb and inspect the base of the hair shafts within a quarter inch of the scalp. You may see crawling lice, but it is more probable that you will see nits (lice eggs) firmly attached to the hair shaft. Although many children have no symptoms, some children experience an itchy scalp, a feeling of tingling or movement in the hair or scratch marks on the scalp.
If you suspect or confirm that your child has head lice, please contact your pediatrician and the school nurse regarding treatment. Please complete the “Head Lice Proof of Treatment Checklist” and bring your child to the school nurse.
Head Lice Forms
Click on the links below to download the Checklist and Information.
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Immunization Summary
District Immunization Summary
The District is required to make publicly available the immunization data they are required to submit to the State Board of Education by November 15. Immunization data made publicly available must be identical to the data the school district has reported to the State Board of Education. 105 ILCS 5/27-8.1(6)
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Medication Information & Forms
The purpose of administering medication in school is to help each student maintain an optimal state of health to enhance his or her education. The administration of medication to students should be discouraged unless absolutely necessary for the student’s health.
Medications should be limited to those required during school hours which are necessary to maintain the student in school and those needed in the event of an emergency.
All medications given in school, including non-prescription drugs, shall be prescribed by a licensed prescriber on an individual basis as determined by the student’s health status.
Medication must be brought to the school in a container, labeled appropriately by the pharmacist or licensed prescriber. OTC (non-prescription) medication shall be brought in with the manufacturer's original label with the ingredients listed and the child's name affixed to the container.
Medication Forms
Click on the links below to download the necessary forms.
Board Policy 7:270 Administering of Medications (SCROLL TO POLICY 7:270)
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Middle School Sports Forms
Thomas Middle School and South Middle School are members of the Illinois Elementary School Association (IESA). According to their guidelines, in order for a student to try-out, practice, or play a sport, a current completed Certificate of Child Health Examination signed by a properly licensed health provider must be on file before sport try-outs.
Middle School Sports Forms
Click on the links below to download the necessary forms.
Middle School Sports Physical Form
Middle School Sports Example Parent Letter
Parents and/or guardians of students who wish to participate in extracurricular athletics/intramurals, must fill out and complete the forms below.
Permission to Participate in Extra-Curricular Athletics/Intramurals
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Physical Exam Information, Forms, & Immunization Data
The State of Illinois requires all children to present evidence of having had a physical examination, including all required immunizations, upon entry to a public school for the first time, preschool, kindergarten and sixth grade.
Physical Exam Forms
Click on the links below to download a list of required immunizations and the physical examination form (Certificate of Child Health Examination).
Religious Exception Requirements - Form
Physical Exam Form- Certificate of Child Health Exam
Physical Exam - Certificado de Examan de Salud del Niño(a)
Immunization Requirements
Click on the link below to download a list of required immunizations.
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Release of Information Docs
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Seizure Information & Forms
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Vaping & E-Cigarettes
"Vaping" is the act of inhaling vaporized liquid or aerosol through an electronic cigarette or other device, such as a vape pen. The device heats up via a battery-operated coil, turning the liquid into an aerosol that is inhaled and exhaled. The liquid can contain nicotine, water, flavor, chemicals, and other substances. The health risks associated with vaping are still being investigated, but there is a growing body of evidence to support dangers associated with these devices (National Center on Addiction and Substance Abuse).
eCigarettes and other vaping devices are not allowed on District property. District 25 is committed to educating students and families about the risks associated with vaping. There is a common misconception that vapes contain only water and flavoring, thus making them harmless. Please use the links below to better understand vaping and to support conversations with your children.
Vaping Handout | Omni Youth Services
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Vision Forms
All Illinois children in Kindergarten or upon first entry into an Illinois school beyond kindergarten are required to have an eye examination within one year of entry.
Each child is required to present proof of an eye examination by an optometrist or ophthalmologist, prior to October 15 of the school year.
Vision Forms
Click on the links below to download the necessary eye information forms.
- Dryden Elementary School
- Dryden Elementary, South Middle School, Westgate Elementary
- Dryden Elementary, Westgate Elementary, Windsor Elementary
- Greenbrier Elementary School
- Greenbrier Elementary, Ivy Hill Elementary, Olive-Mary Stitt Elementary, Patton Elementary
- Greenbrier Elementary, Ivy Hill Elementary, Windsor Elementary
- Ivy Hill Elementary School
- Olive-Mary Stitt Elementary School
- Olive-Mary Stitt Elementary, Patton Elementary, Thomas Middle School
- Patton Elementary School
- South Middle School
- Thomas Middle School
- Westgate Elementary School
- Windsor Elementary School
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