Health and Safety

Medical Forms Needed for Kindergarten Students
August 7, 2015

Dear Parents,
Hello! You are receiving this email because you have an Intercultural student who is Kindergarten age (5 years old on or before September 1, 2015).
The State of Illinois requires parents of Kindergarteners to submit the following three medical forms:
  1. Proof of Medical Exam/Immunizations
  2. Proof of Vision Exam
  3. Proof of Dental Exam
Forms are due to the school no later than October 15th, 2015. If you have not submitted these forms recently, please click the links above to download them.
Please note:
  • If you cannot get in to see your doctors 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.
  • Medical and Vision exams must be within a year of the start of school this year (from appointments dated no earlier than September 8th, 2014).
  • Dental exams must be from appointments dated no earlier than November of 2014. 
  • If you feel you qualify for a vision of dental waiver, please complete the waiver page of the relevant form and submit it to the school.
  • If you feel you meet the State requirements for an exemption to the medical/immunization requirements, please contact me for more information.
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
flimoncelli@nullinterculturalmontessori.orgChicago campus / 114 S. Racine Suite 100 Chicago, IL. 60607 / (312) 265-1514Oak Park campus / 301 S. Ridgeland Oak Park, IL. 60302 / (708) 848-6626