• Digital Option for 2020-21 School Year

    Welcome to Victor J Andrew High School. All incoming freshman must complete a health questionaire as well as complete and submit all the required medical and dental forms before your student can begin school in the fall. Below are the deadline dates for this information. This online form submission process has been made available to ease the process of turning in all medical forms for incoming Freshman and returning students. 
    The district is excited about the modernization of this process and appreciates families’ participation utilizing this new system.  Once submitted, all documents will be reviewed by staff to assure completeness.

     

    STEP 1: Go to the online form here (Emergency and Health Related Information form)  to complete the Health questions AS SOON AS POSSIBLE. Make sure you have your student's ID number handy.

                                 

    STEP 2: Download and print the health forms that will need to be completed. 

             

    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 with immunization dates and a dental examination 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

    Asthma Action Plan: Asthma Action Plan for students with asthma  

    Allergy and Anaphylaxis Emergency Plan: Anaphylaxis Action Plan for students with severe allergies 

    Diabetes Medical Management Plan: Diabetes Medical Management Plan for students with Type 1 Diabetes

    Seizure Action Plan: Seizure Action Plan for students with a seizure disorder or epilepsy

     

     

    Please upload or submit health forms to the Nurse's Office, by May 1, 2021  

     

    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.