• Sandburg Nurse's Office

    Click here for the 2021-22 School Year Digital Forms


    EMERGENCY INFORMATION SHEET -Due by February 15, 2021

    CERTIFICATE OF CHILD HEALTH EXAM  -Due by May 1, 2021     
    State of Illinois Child Health Exam form must be completed and signed by a licensed physician, APN, or PA. A sports physical is NOT acceptable for this requirement.

    Form MUST be dated on or after August 13, 2020 and show the following immunizations:

    •  Tetanus Diphtheria, Pertussis series with Tdap booster 
    •  Two (2) doses of measles, mumps, rubella vaccine (MMR) – 1st dose having been given on or after the 1st birthday 
    •  Polio vaccine series with booster given on or after the 4th birthday 
    •  Two (2) doses of varicella vaccine (the 1st dose having been given on or after the 1st birthday)
    •  Three (3) doses of Hepatitis B according to the required schedule 
    •  One dose of Meningococcal vaccine on or after 11th birthday for freshman
    • The Heath History section on page 2 must be completed and signed by the parent/guardian.  
    • State of Illinois Child Health Exam form will satisfy the athletic department sports physical requirement for freshman year for a period of 13 months from exam date.  Athletes do not need a separate sports physical for their freshman year. If a sports physical is completed by your doctor, please fax it directly to the athletic department at (708) 737-7722.

     DENTAL EXAMINATION -Due by May 1, 2021

    Completed forms should be submitted via ONLINE to Laserfiche https://lf.d230.org/Forms/Medical


    Students entering 12th grade in the State of Illinois are required to have proof of the following immunization from their physician by May 1, 2021 

    • A dose of Meningococcal conjugate vaccine on or after their 16th birthday. 

    Documentation should be submitted ONLINE to Laserfiche https://lf.d230.org/Forms/Medical 

    Sandburg Health Services

    Office Staff

    cs nurses office

    Diane Karamagianis, BSN, RN, IL PEL-SN
    Carl Sandburg High School
    Illinois Certified School Nurse
    Certified Vision and Hearing Screening Technician


    Lesley Caponigro
    Carl Sandburg High School
    Health Services Office Secretary

    Our Fax # is 708-737-7721

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