Nurses - Trisha Modeen MSN RN PEL-CSN
- Kara Kistenfeger RN
Office Phone - (815) 431-2461
- (815) 431-3388
Office Fax - (815) 431-3350
For the 2023-2024 school year, all students must be up-to-date with physical examination and immunization requirements. All completed forms must be emailed to tmodeen@ottawahigh.com or turned into the school health office before August 14, 2023. Students who have not submitted their requied health documents by the first attendance day of school may be excluded from school until notification has been received by District 140, the required health documents have been provided.
Physical Examination Information:
* All students entering 9th grade are required to have a current physical examination completed via the approved Illinois Department of Public Health Form. The parent portion on the upper backside of the form must be completed and signed.
* A sports physical does not meet the physical requirement.
* A current physical is one that was completed within one year of August 14th, 2023.
Immunization Requirement Information:
* All students must be up-to-date with the State of Illinois immunization requirements.
* All students entering sixth, seventh, eighth, ninth, tenth, and eleventh grade must show proof of receiving one dose of Meningococcal vaccine (meningitis).
* All students entering twelfth grade must show proof of receiving one dose of Meningococcal vaccine after the age of 16.
* All students entering grades six through twelve must show proof of receiving one dose of the Tdap vaccine.Â
Seniors & Freshmen - Please Read - Deadlines
SENIORS
MENINGOCOCCACAL Conjugate Vaccine(MCV)
RECORDS ARE DUE TO THE NURSE BY
10/13/23
FRESHMEN
PHYSICALS
&
IMMUNIZATION RECORDS
ARE DUE TO THE NURSE
BY
10/13/23
Dental Exams are due by May 15, 2024
Parents: Click on the links on the left hand side of page to print a copy of Health forms for your Physician.
9th Grade Requirements:
1. 9th Grade Physical/Immunization Form
2. Health History Form
3. Meningococcal Vaccine - MCV Dose required.
4. Dental Exam (Due by May 15th of current school year.)
10th Grade Requirements:
1. Health History Form - For New/Transfer-In students.
2. Sports Physical if participating in any Sports Team.
Immunizations must be up to date.
**Immunization Records can be viewed in Family Web Access Account**
11th Grade Requirements:
1. Health History Form - For New/Transfer-In students.
2. Sports Physical if participating on any Sports Team. Immunizations must be up to date.
**Immunization Records can be viewed in your Family Web Access Account**
12th Grade Requirements:
1. Health History Form - For New/Transfer-In students.
2. Meningococcal Vaccine - 2nd MCV Dose required at the Start of Senior Year or after turning 16 years of age. One dose required if received after age 16.
3. Sports Physical if participating on a Sports Team. Immunizations must be up to date.
**Immunization Records can be viewed in your Family Web Access Account**
Parents - Click on the links on the upper left hand side of this page to print a copy of Health forms for your Physician.
Mandatory Health Requirement Checklist
Check when complete |
Event |
Timeline |
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Emergency Information Sheet This form should be completed and turned in at registration |
Aug 4, 2023 |
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Certificate of Child Health Exam State of Illinois form must be completed and signed by a licensed physician, APN, or PA. This requirement applies to transfer students also. Note: Obtaining a copy of your child’s 6th grade physical may help your physician complete the immunization section of this form. Form MUST show the following immunizations:
- Tetanus Diphtheria, Pertussis series with Tdap booster
- Two (2) doses of measles, mumps, rubella vaccine (MMR) – 1st dose having been given on or after the 1st birthday
- Polio vaccine (IPV) series with booster given on or after the 4th birthday
- Two (2) doses of varicella vaccine (the 1sst dose having been given on or after the 1st birthday. History of varicella (chickenpox) disease is acceptable if verified by health care provider, school heal professional or health official.
Three (3) doses of Hepatitis B according to the required schedule
- Two (2) doses of Meningococcal vaccine administered at least 8 weeks apart or one (1) dose after the 16th birthday is required for all SENIORS.
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- Parents/Guardians will complete and will complete and sign the Health History section on the back of the physical form. Incomplete or unsigned forms will be returned.
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- An Asthma Action Plan is required from the doctor for all asthmatic students.
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- Make a copy of this completed form for your records
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- Deliver or mail the completed form to Ottawa Township High School, 211 E. Main St. Ottawa, IL 61350, Attention Nurse’s Office or FAX to Trisha Modeen, RN, at 815/431-3350 or email to tmodeen@ottawahigh.com.
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- SPORTS PHYSICALS (Freshmen do not need a separate sports physical). In order for a Freshman student’s health exam to be eligible for the full school year, it should be dated AFTER May 1, 2023. Copy the Health Exam Form for the Athletic Department. Keep a copy for yourself. Send the original to the Nurse as noted above.
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Required for 9th Grade and for students entering the Illinois School System for the first time. |
August 14, 2023 |
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State of Illinois Eye Examination Report Required for students entering the Illinois School System for the first time. |
On Registration Day |
LaSalle County Health Department (815/433-3366) provides immunization clinics by appointment only.
Contact Trisha Modeen, RN PEL-CSN, at tmodeen@ottawahigh.com with any questions. 815/431-2461 (office phone), or 815/431-3350 (office fax).
End of Year Medication Pick Up
It is the parent/guardian’s responsibility to pick the medication/Epi-Pens/Diabetic Supplies/Nebulizer Equipment up by the last day of school. Students will not be allowed to pick this m
edication up, it will only be released to the parent/guardian. The last day of student attendance for the 2023-24 school year will be May 16th, 2024. All medication left in the Nursing Office after May 16th will be destroyed. If you are unable to pick up the medication by May 16th please contact Trisha Modeen, RN PEL-CSN (School Nurse), at (815) 431-2461 by May 13th, 2024 to make different arrangements.
If your student will continue the use of medication/Epi-Pens/Diabetic Supplies/Inhaler/Nebulizer Equipment for the 2023-2024 school year, you will be required to complete new forms and have the student’s physician sign approval forms. These forms will be required before any medication is left in the Nurse’s office. Parent permission and MD Permission forms are located on the OTHS Website under Parent Resources in the “Nurse Office” link. You may also stop by the Nursing Office, room 205, to discuss your student’s health needs with Trisha Modeen, RN, and pick the forms up.
If you have any questions please contact Mrs. Modeen at (815) 431-2461.
Nurses - Trisha Modeen MSN RN PEL-CSN
- Kara Kistenfeger RN
Office Phone - (815) 431-2461
- (815) 431-3388
Office Fax - (815) 431-3350
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• Notification Letters to Parents
