Emergency Forms - All students need an updated emergency form on file at the start of each school year.  Please keep the emergency form up-to-date throughout the school year.

• Emergency Form in English
• Emergency Form in Spanish​

Media Consent Form - This form must be completed once upon initial registration. 

• Media Consent Form in English
• Media Consent Form in Spanish

Student Health Forms - The Student Health Forms Booklet includes all the forms that parents and caregivers must complete for their students at the beginning of the year. 

• Coming Soon for the 2022-2023 School Year

Dental Consent Form - The dental consent form provides your child's school with permission to do a dental check-up when dental services are scheduled at the school.

• Dental Consent Form in English
• Dental Consent Form in Spanish

Vision Consent Form - The school-based vision consent form provides your child's school with permission to do a vision exam when vision services are scheduled at the school.

• Vision Consent Form in English
• Vision Consent Form in Spanish

Medications in School

Requirements For Students to Receive Medication During School Hours

Please help us manage student medications by following the guidelines below. When a student’s health condition requires medication during the school hours, we ask that the parent provide the following:

• ALL medication (prescribed or over the counter) must be dropped off in the main office by the parent.  The medication must be handed to Mrs. Gonzalez, the school clerk.
• Any medications necessary to treat the student’s health condition must be in the original container.
• Parent/guardian will complete and/or have the child’s doctor complete and submit the appropriate forms for student to receive medication:
  • Parent Request for Administration of Medication to a Student
  • Parent Request for Self-Administration of Medication
  • Physician's Request for Self-Administration of Medication
  • Physician's Request for Administration of Medication to a Student
• Forms completed by your child’s physician can be faxed to  (773) 534-2578.
  • Please reach out to Ms. Vy, the school nurse, Mrs. Gonzalez If you have any questions @ 773-534-2680 ext 0

For Prescription Medication

• Physician Request must include:
  • Name of medication, dosage, mode of administration
  • Frequency and time of administration
  • Special circumstances in which the medication should be administered

Over the Counter Medication

• Students requiring over the counter medication during school hours must be authorized in writing by the students parent/guardian
• Students are NOT allowed to carry over the counter medications

In order to effectively plan for and manage ongoing student health needs at school, parents/guardians are asked to promptly notify the school upon their child being diagnosed with any chronic or acute conditions, regardless of whether medication is administered during school hours.  Please contact Ms. Cochran to discuss a 504 plan to address the daily management of chronic or acute conditions.  

Chronic or acute conditions can include, but are not limited to, asthma, diabetes, and food allergies.