Medical Forms and Requirements

Click here to view or download the Health Form Requirements Letter

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The following state-required forms must be submitted to complete Admissions:

For children going into Nursery:

  • Copy of the Birth Certificate
  • Medical Form with health history completed signed by a parent
 For children going into Kindergarten/Pre-1A:
For children going into 2nd Grade:

 For children going into 6th Grade:
For new students K- 8:

  • Copy of Birth Certificate
  • Medical Form with health history completed signed by a parent
  • Eye Form or Eye Waiver (Only required if the student is moving from out of Illinois)
  • Dental Form or Dental Waiver (Only required if the child is going into Kindergarten/Pre-1A, 2nd or 6th Grade)

Click here to download the Medical Action Plan (MAP) Form

Click here to download the Asthma Action Plan Form

Health forms can be submitted in any of the following ways:

  1. Uploaded to our registration portal – visit portal.jdbyytt.org, after logging in, click on the forms upload tab
  2. Emailed to medicalforms@jdbyytt.org
  3. Faxed to 773-465-8982
  4. Mailed to the JDBY-YTT Executive Office at 6122 N. California Ave. Chicago IL 60659
  5. Dropped in the Executive Office Mailbox located outside of 6122 N. California Ave.

For any questions regarding the Health Forms and Requirements please Contact the Executive Office

Note:

  • Dental form must be from an exam performed on or after November 1, 2022
  • Eye exam form must be from an exam performed on or after September 1, 2022
  • Medical forms must be from an exam on or after September 1, 2022 and with health history completed and signed by a parent
  • The policy of the school is for all students to have all state-required vaccinations and immunizations. Only state-recognized medical exemptions will be considered for exceptions, and must be submitted and accepted by the school prior to admittance.