Below please find the required medical documentation to assist you for the 2020-2021 school year.  These forms should be completed as soon as possible and returned to the school office by August 1st, 2020.  If your child’s medical forms are not submitted by August 1st, 2020, he/she will not be able to attend the Meet and Greet and the start of school.  For additional medical questions, please reference the Health section in the Parent-Student Handbook on the Family Resources Page

NEW Preschool students for the 2020-2021 school year ( this covers all new preschool students for PK3 or PK4)

  • Certificate of Child Health Examination

  • Updated Immunizations​

  • A complete and signed health history
    (on the top of page two of the health form)

  • This document must be signed by a physician, physician's assistant or nurse practitioner.

  • Dental Exam​

  •  EMERGENCY CARE PLAN: If your child has a medical condition that requires medication administration, please submit Medication Authorization Form (completed by physician).  In addition, a Food Allergy Action Plan (completed by physician) is required for all students with food allergies and an Asthma Action Plan (completed by physician) is required for all students with asthma.   The Diabetic care plan and the Seizure care plan also needs to be completed by a physician for students with those medical conditions.

  • Kindergarten

  • NEW  1st - 8th Grade Students

    • Certificate of Child Health Examination

      • Updated Immunizations​

        • A new law from the Illinois Department of Public Health now requires 2 doses of MMR​ and 2 doses of Chicken Pox Vaccine before entering Kindergarten.

      • A complete and signed health history
        (on the top of page two of the health form)

      • This document must be signed by a physician, physician's assistant or nurse practitioner.

    • Dental Exam​

    • Eye Exam

    •  EMERGENCY CARE PLAN: If your child has a medical condition that requires medication administration, please submit Medication Authorization Form (completed by physician).  In addition, a Food Allergy Action Plan (completed by physician) is required for all students with food allergies and an Asthma Action Plan (completed by physician) is required for all students with asthma.   The Diabetic care plan and the Seizure care plan also needs to be completed by a physician for students with those medical conditions.

MEDICAL FORMS

Any students needing medication at school must provide all paperwork and 2 forms of each of the medications by August 1st, 2020 prior to attending school. If your child does not have his/her emergency medication at school by August 1st, he/she will not be able to attend the Meet and Greet or the start of school.

  • Medication must not be expired

  • 2 forms of the medication are needed for classroom emergency backpacks and one kept in the nurse's office.

All Second Grade

  • Dental Exam​

  •  EMERGENCY CARE PLAN: If your child has a medical condition that requires medication administration, please submit Medication Authorization Form (completed by physician).  In addition, a Food Allergy Action Plan (completed by physician) is required for all students with food allergies and an Asthma Action Plan (completed by physician) is required for all students with asthma.   The Diabetic care plan and the Seizure care plan also needs to be completed by a physician for students with those medical conditions.

All Sixth Grade

  • Certificate of Child Health Examination

    • Updated Immunizations​​

    • A complete and signed health history (on the top of page two of the health form)

    • Proof of DTap Vaccine

    • This document must be signed by a physician, physician's assistant or nurse practitioner.

  • Dental Exam​

  •  EMERGENCY CARE PLAN: If your child has a medical condition that requires medication administration, please submit Medication Authorization Form (completed by physician).  In addition, a Food Allergy Action Plan (completed by physician) is required for all students with food allergies and an Asthma Action Plan (completed by physician) is required for all students with asthma.   The Diabetic care plan and the Seizure care plan also needs to be completed by a physician for students with those medical conditions.

OSM Single Color Reverse.png

Old St. Mary's School,  1474 South Michigan Avenue, Chicago, Illinois 60605 |  info@osmschool.com  |  Tel: 312-386-1560

 Office Hours: Mon - Fri  7am-3:30pm

©2019 by OLD ST. MARY'S SCHOOL