Health and Safety

Medical Forms Needed for 2nd Grade Students
August 7, 2015

Dear Parents,
Hello! You are receiving this email because you have an Intercultural student who is 2nd grade age (7 years old on or before September 1, 2015).
The State of Illinois requires parents of 2nd graders to submit the following form:
Forms are due to the school no later than October 15th, 2015. If you have not submitted this form recently, please click the link above to download it.


Please note:
  • If you cannot get in to see your dentist before October 15th, you may schedule an appointment within 60 days of the deadline and report that appointment date to the school. You may then submit your form after your approved appointment occurs.
  • Dental exams must be from appointments dated no earlier than November of 2014. 
  • If you feel you qualify for a dental waiver, please complete the waiver page of the relevant form and submit it to the school.
If you have any questions please feel free to contact me at
Thank you for helping us comply with the State’s requirements!
Frances Limoncelli
Admissions Director
Intercultural Montessori Language School
312-265-1514 o
773-450-8177 m

Chicago campus / 114 S. Racine Suite 100 Chicago, IL. 60607 / (312) 265-1514Oak Park campus / 301 S. Ridgeland Oak Park, IL. 60302 / (708) 848-6626