Dental Exam Forms and Waivers

April 10, 2017

The state of Illinois requires all students in Kindergarten, 2nd, and 6th grades to have a dental exam, with the proof of exam by a dentist turned into the school prior to May 15.  If unable to complete the dental exam by a dentist, then the school must receive a dental exam Waiver prior to May 15, completed by the parent / guardian.

Failure to present proof of exam or waiver may result in the school holding the child’s report card.
For further information or questions, please contact the building school nurse.

Dental Exam Form:  English        Spanish

Dental Exam Waiver: English      Spanish