Health & Medical
Health Forms
Forms and documents related to student health, medical needs, medications, physicals, immunizations, and other required health information.
- Health Examination
- Dental Examination
- Immunization Records/Requirements
- Asthma Form
- Medication Authorization
- Allergy/Medical Action Plans
- Diabetes Medical Management Plan
Health Examination
Dental Examination
Immunization Records/Requirements
Asthma Form
An Asthma Action Plan is Required for All Students with Asthma
Illinois Public Act 099-0843 requires schools to request an Asthma Action Plan (AAP) from parents of students with asthma. The asthma action plan must be written by a doctor, kept on file in the office of the School Nurse, and be updated annually. This requirement took effect on January 1, 2017. Your child is also required to have a School Medication Authorization form on file for any medications they need to take at school.
Both required forms can be found below:
Medication Authorization
Allergy/Medical Action Plans
Diabetes Medical Management Plan
Athletic Health Forms
Medical and health forms required for participation in school athletics.
Athletic Physical
Athletic Medical Clearance
Illinois high school student athletes must have a current sports physical and signed consent forms on file with AJCHS's athletic office before participating in any tryouts, practices, or games.
Requirements for Athletic Clearance
- Sports Physical Exam: Students must pass an annual pre-participation physical evaluation performed by an approved healthcare professional, such as a licensed physician (MD/DO), advanced practice nurse, physician assistant, or certified athletic trainer under appropriate supervision.
- Validity Period: In Illinois, an athletic physical is valid for 395 days from the exam date and cannot expire in the middle of a sports season.
- Required Forms: Athletes typically use the IHSA Pre-Participation Examination Form alongside signed consent forms covering concussion education and acknowledgments.
- School vs. Sports Physicals: An annual general school physical required for specific grade levels (like 9th grade) does not automatically replace sports clearance unless completed within the correct timeframe and explicitly accepted by the school district as meeting athletic requirements.
Concussion Information & Acknowledgment
A concussion is a type of brain injury resulting from a bump, blow, or jolt to the head that causes the head and brain to move rapidly back and forth. Though a concussion may seem to be an ‘invisible injury’, a concussion can affect a student physically, cognitively, and emotionally. These symptoms can significantly impact both learning and schoolwork. Physical symptoms such as headache, dizziness, and visual changes may interfere with the student’s ability to focus and concentrate. Cognitive symptoms may impact the ability of the student to learn, memorize, and process information as well as keep track of assignments and tests.
The goal of the Concussion Protocol is to aid in recovery and avoid overexerting the brain to the level of triggering or worsening symptoms. The Concussion Protocol consists of two parts: Return to Learn (RTL) and Return to Play (RTP). Please see the link below for the individual stages of the concussion protocol and additional information about concussions.
Health Information
Information about immunizations, vaccinations, diabetes, cardiac emergencies, and other student health topics.
