Streamwood

On this page you will find the forms needed to help your student during school that may have a health condition, or need medication at school. The State of Illinois Physical Examination and Immunization form is also available here.

A Medication Administration Permission form is required for all medications in school, including those that can be bought over the counter without a prescription.

Link to the District u-46 Health Services Web page for futher district health information and forms: 

 u-46 Health Services Department

 Health Forms

Forms:

*  State of Illinois Physical Examination and Immunization form:                       

    State of Illinois Child Health Examination Form English                                                               

    State of Illinois Child Health Examination Form w/Spanish Parent Section

*  Medication Administration Permission form:  

    Medication Administration Permission Form English

    Medication Administration Permission Form Spanish

*  Asthma Assessment and Asthma Action Plan forms:                                                                      

    Asthma Action Plan Order Form

    Asthma Assessment Form Spanish

*  Allergy Assessment and Emergency Plan forms:

    Bee Sting Allergy Assessment Form English

*  Food Allergy Assessment and Emergency Plan forms:

*  Diabetes Care Plan forms:

    Continuous Glucose Monitoring Parent Permission Form English  

* Seizure Assessment and Emergency Plan forms:  

   Seizure Disorder Parent Assessment Form English

   Seizure Disorder Emergency Care Plan