Health Care Requirements & Forms

Please see all the health requirements for your student in the chart below. The form name links directly to the form you should fill out to submit to the Health Office.

HCA Students

FormPS/PKK123456789101112
Physical Exam FormXX     X  X   
Dental Exam Form X X   X  X   
Vision Exam Form X            

Transfer Students

 

Required Vaccine Doses* by Grades

VaccinePS/PKK123456789101112
Tdap       1      
DTP/DTaP34444444444444
OPV/IPV (Polio)34444433333333
HIB**1             
HepB3      3333333
Varicella (Chickenpox)12222222222222
MMR12222222222222
PCV(Pneumonia) series
MCV4
       111    
(Meningococcal)       1     2
  

*Unless the student shows proof of having had the disease or submits a medical or religious objection letter
**Any child 5 years of age or older shall not be required to show proof of HIB vaccine

Please visit IDPH for minimum immunization requirements as listed here.

Physical Forms and Immunizations – Grades Preschool, K, 6 and 9 

School Physical Examination Forms and required immunizations must be submitted prior to the first day of school in order for students in grades preschool, K, 6 and 9 to begin school.

The physical exam must be completed within one calendar year prior to the start of school and must fulfill all Illinois State Board of Education and Illinois Department of Public Health requirements.

1. Students will not be allowed to begin school without a submitted physical examination form and required immunizations.  If you cannot   see your doctor, there are a number of places that offer these services including immediate care centers and drug stores with clinics.

2. Students who are new to HCA and IL schools must submit health records within 30 days of entering school.  Transferred health records will be reviewed by the school nurse for compliance with Illinois school health requirements.

3. Students who have not received immunizations due to religious beliefs should present a written note explaining their personal religious objections. As of October 15, 2015, the state of Illinois requires this exemption form. These will be reviewed for approval by our administration.

4. Students who have not received immunizations due to medical objections should present a note from the physician stating the medical condition that contraindicates the immunization.

5. School Physicals for grades 6 and 9 will count as sport physicals

Dental Examination Forms- Grades  K, 2, 6 and 9 

Illinois State law mandates that all grade  K, 2, 6 and 9 students and out of state transfers present proof of a dental examination prior to May 15 of that school year and must be completed within 18 months prior to the required date.

waiver has been established by the Illinois Department of Public Health for students who show undue burden or lack of access to a dentist.

Kindergarten Vision Examination Forms- Grades K

Illinois State law mandates that all incoming grade K and out of state transfers must present a vision exam report conducted by a physician who provides a complete eye exam or a licensed optometrist.

This report must be submitted to the school by October 15 of the school year and must be completed within one year prior to the required date.

waiver has been established by the Illinois Department of Public Health for students who show an undue burden or lack of access to an ophthalmologist or optometrist.

 

NOTICE OF NONDISCRIMINATORY POLICY AS TO STUDENTS

Harvest Christian Academy admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other school-administered programs.