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Forms

Medical Forms

Prescription Medication at School Form

School Physical Form

Eye Exam Form

Dental Exam Form
 

When do you need to submit Medical Forms?

Medical forms need to be submitted to school by October 1st.

Physical and Up-to-Date Immunization:

  • Preschool (first time enrolling, good for 2 years if they are in our Pre3 class)
  • Kindergarten
  • 6th Grade
  • New to an Illinois School

Eye Exams

  • Kindergarten
  • New to an Illinois School

Dental Exams

  • Kindergarten
  • 2nd Grade
  • 6th Grade

Sports Physicals

  • 5th - 8th Grade if participating in a school sport (6th grade may use a mandatory physical.)


Physical forms may be collected on Meet the Teacher Night in August. In addition, the forms can be mailed to the school, faxed to the school at 217-546-0291 or emailed to salem@ctkcougars.com. If there are any questions, please call the school at 217-546-2159.