Student Health Requirements/Forms

Forms can be downloaded and partially be completed electronically.
Must be printed to be completed and signed by a physician.
Must be provided to District Office upon completion. Completed forms can also be uploaded through the online registration portal.

Click here for detailed list of health needs by grade level and locations for obtaining health-related services.

Select the links below to view, download, and print medical, dental and/or vision forms. 


Icon of a medical shot needle
Medical Form (English)
Medical Form (Spanish)

Icon of a dental tooth
Dental Form (English)
Dental Form (Spanish)

Icon of an eye
Vision Form (English)

   New Students
Grade 6 Returning

New Students
Grade 2

If a dental examination
cannot be obtained...

Complete Dental Waiver
Dental Waiver (English)
Dental Waiver (Spanish)
Form can be completed electronically. 

New Students
Grade 6

If a vision examination
cannot be obtained...

Complete Vision Waiver
Vision Waiver (English)
Form can be completed electronically. 
Illinois Department of Health required and recommended Immunizations

Detailed descriptions of health needs by grade.

If your student is in need of a physical exam (school or sports) and/or vaccines, Advocate Children's Hospital will be providing free services at Mundelein High School on July 30, from 9:00am-4:30pm. The exams are for those who do not have Medicaid or do not have insurance. There is no need to make an appointment, just simply stop by. Children who receive a physical exam or vaccinations will receive a free backpack and school supplies courtesy of American Dream Realty of Mundelein.
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