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Nurse’s Office and Student Health Services

The Nazareth Academy Nurse’s Office provides a coordinated system of healthcare to ensure every student is healthy, safe, and supported. Through assessment, education, and intervention, we collaborate with parents and faculty to enhance student success and independence.

Erin Burba

School Nurse
BSN, RN, PEL-CSN
School: 708-387-8577
School Fax: 708-354-0109

Required Health Forms

To ensure a smooth start to the school year, please download and submit the necessary forms below.

Mandatory State Requirements

State of Illinois Certificate of Child Health Exam (Physical Form)
Required for all incoming freshmen and transfer students.

Dental Exam Form
Required for incoming freshmen only.

State of Illinois Meningitis Vaccine Letter
Required for all Seniors.

State of Illinois Eye Examination Report
Required for out-of-state transfer students only.

Athletics (IHSA) Forms

Required yearly for student-athletes in grades 10, 11, and 12.

IHSA Pre-Participation Physical Form
IHSA Pre-Participation Physical Form (En Español)
 

Medical Action Plans & Medication Policies 

If your student has specific medical needs, please return the following completed forms to the School Nurse prior to the first day of school.

Daily Medications
School Medication Procedures & Authorization

Over-the-Counter Medications
School Stock Medication Authorization Form

Food Allergies
Food Allergy Action Plan  

Asthma
Asthma Action Plan

Seizures
Seizure Action Plan

Diabetes

Diabetes Care Plan
Diabetes Educational Info

Policies & Confidentiality

Illinois Religious Exemption Form

Concussion Policy

Cardiac Emergency Response Plan


A Note on Confidentiality: Nazareth Academy takes the privacy of student health information seriously. Individual data is shared only with essential faculty and staff on a "need-to-know" basis to protect student safety and learning. For questions regarding health privacy, please contact the School Nurse directly.