• Turning in Health Forms for the 2020-21 School Year

    Welcome to Victor J Andrew High School. All incoming freshman must have a completed health questionnaire and physical exam form on file with the school Nurse's Office, before your student can receive their 2021-2022 school schedule in August. Students who have not turned in the required documents may also be subject to a delayed school start date. Below are the deadline dates for this information. 

    For the 2021-2022 school year, the health form submission process has moved online. This online form submission process has been made available to streamline the process.  Once submitted, all documents will be reviewed by staff to assure completeness. Please note that document review make take up to 2 weeks.

     STEP 1: Download, print and complete applicable health forms for your student (see below)

     STEP 2: Click here to complete the online Emergency-Health Information form AND/OR Upload Health forms 

     

    Forms for Incoming Freshmen or Transfer Students 

    Certificate of Child Health Exam Form required for all freshmen and students new to the district. Must be dated on or after August 15, 2020

    State of Illinois form must be completed and signed by a licensed physician, APN, or PA. Form MUST 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 
    •  One dose of Meningococcal vaccine on or after the 16th birthday for incoming seniors.

    All incoming Freshmen students must have a complete physical exam form (with immunization dates) on file with the School Nurse before they can receive their schedules in August.  

     

    Dental Examination Form required for all freshmen and students entering an Illinois school for the first time. Must be dated on or after November 15, 2020

    Dental Examination Waiver Form

     

    State of Illinois Eye Examination Report: required for students entering the Illinois School System for the first time.  Must be dated within 1 year of first entry into Illinois school system

    State of Illinois Eye Exam Waiver Form

     Form for Incoming Seniors Meningococcal Immunization form

     

    Forms for students needing Medication at school Medication Authorization Form: 

    For daily and as needed medications at school.  This form needs to be filled out for prescription and over the counter medications, and must be signed by a parent/guardian and the child's doctor.

     

    Forms for students with Chronic health concerns (click on the underlined document title to be take to a downloadable form)

     Asthma Action Plan: For students with Asthma    

    Allergy and Anaphylaxis Emergency Plan: For students with severe Allergies 

    Diabetes Medical Management Plan For students with Type 1 Diabetes

    Seizure Action Plan: For students with a Seizure disorder or Epilepsy

     

    Please upload health forms to the Nurse's Office by May 1, 2021. Failure to do so may result in a delay in your student's summer schedule release.

     

    Parents interested in submitting documents digitally should following the steps below:

    If using a Smartphone:

    1. Click on https://lf.d230.org/Forms/Medical
    2. Fill out the form and upload the document(s).
    3. Provide electronic signature at the bottom of the form and click submit.

    If using a computer (Desktop, laptop, etc.):

    1. Click on https://lf.d230.org/Forms/Medical
    2. Fill out the form and upload the document(s).
    3. Provide electronic signature at the bottom of the form and click submit.