• Students
  • Parents
  • Staff
  • Quicklinks
    • Teachers and Staff
    • Calendar
    • Lunch Menu
  • District Home
  • About
    • Daily Schedule
    • Meet the Principal
    • School Report Card(opens in new window/tab)
    • Contact
    • Hickory Grove History
    • Building Walkthrough
    • Handbook
  • PTO
  • Bulletins
  • Registration
    • New Family Registration Checklist
    • Required Immunizations and Examinations
    • Registration Medical Forms
    • K-5 Supply List
    • Residency Requirements
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Hickory Grove
Elementary School
"Empowering all students to reach their individual potential"

  • Students
  • Parents
  • Staff
  • Quicklinks
    • Teachers and Staff
    • Calendar
    • Lunch Menu
  • District Home

District Home

  • About
    • Daily Schedule
    • Meet the Principal
    • School Report Card(opens in new window/tab)
    • Contact
    • Hickory Grove History
    • Building Walkthrough
    • Handbook
  • PTO
  • Bulletins
  • Registration
    • New Family Registration Checklist
    • Required Immunizations and Examinations
    • Registration Medical Forms
    • K-5 Supply List
    • Residency Requirements

District Home

Registration Medical Forms

  • Certifcate of Child Health Examination
  • State Certificate of Religious Exemption Form
  • State Dental Exam Form
  • State Eye Exam Form
  • Allergy Action Plan
  • Asthma Action Plan
  • Seizure Action Plan
  • Medication Authorization Form
  • smic Voluntary Student Accidental Insurance
  • CareDox Parent Letter
Hickory Grove Elementary School
2514 West Hickory Grove Road Dunlap, Illinois 61525
P: 309.243.8711
F: 309.243.8772
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