To keep in compliance with the State of Illinois Department of Public Health, students in Kindergarten, 2nd, 6th, and 9th grades are required to have a dental examination performed by a licensed dentist. Proof of dental examination needs to be submitted to the school prior to May 15th of the school year. The examination must be performed and the form signed and dated within 18 months prior to May 15th. You may turn in the forms anytime during the school year. Please contact your dentist to set up an appointment, or if you have had a recent examination, you can have the form completed and submit it to the school office of fax to 815-286-7577. If a child in Kindergarten, 2nd, 6th grade, 9th fails to present proof by May 15th, the school may retain the child's report card until we have received proof of dental examination form or a dental examination waiver. Dental examination waivers apply for students who are enrolled in free or reduced lunch program and are not covered by private or public dental insurance.

We understand that dentists can be difficult to find depending on your type of insurance or the costliness of the procedure. We are pleased to offer SmilePrograms services each year in our elementary building. These pediatric dentists come during a school day and accept all forms of dental insurance. If you do not have dental insurance and cannot pay out of pocket, SmilePrograms may be able to offer assistance. Please watch for the announcement in our Elementary School's January newsletter and for the registration forms to be sent home with your student.

Download Dental Examination Form

Download Dental Examination Waiver