The Cook County Department of Public Health conducts vision and hearing screenings to children enrolled in private grammar schools and daycare centers in suburban Cook County* at the request of the school/center. Screening will only be provided to pre-school, kindergarten, 1st, 2nd and 8th grade students as mandated by the Illinois School Code.
Schools/centers in the North and Southwest suburban Cook County regions will be screened in even school years beginning in the fall of 2006. Schools/centers in the West and South will be screened in odd school years beginning in August of 2005. No school/center will be screened more than once in a school year.
Please make sure to follow these steps to ensure the students in your school can get their needed vision and hearing screenings:
Make sure to fill out the application form completely, and include a copy of the tuition schedule as well as documentation of students at or below 200 percent of poverty and any subsidies received through the Illinois Department of Human Services and/or Department of Children and Family Services. These documents should be faxed to 708-450-5349.
To download a Spanish version of the consent form for vision and hearing services, please click here.
Schools/centers are responsible for obtaining necessary consents for screening including the Cook County Bureau of Health Services HIPAA Acknowledgement (please print out the CCDPH privacy agreement) in advance of scheduled screenings.
You can easily download all necessary forms (consents, releases, screening forms, client/parent notification letters and referrals) from the link on the bottom of this page. Please make sure these are complete at the time of the screening. If necessary, bilingual support must be provided by the school/center.
Follow-up on referrals for abnormal screening tests are the responsibility of the school/center and all follow-up information is to be provided to CCDPH within 45 days of the screening.
Once an application has been received with all required documentation, CCDPH will contact the designated school/center staff within 7 days to schedule the screening. Each screening procedure takes approximately 10 minutes per student. Schools/centers that receive subsidies will be given priority.
It is the goal of CCDPH to provide schools/centers and their children with the highest level of professional services.
To download the application form to request Vision and Hearing screenings, please click here. This form must be sent in with tuition schedule and documentation of students below 200 percent of poverty.
To download the rest of the required forms for the Vision and Hearing Program, please click here. These forms must be complete at the time of screening.
If you are interested in training your personnel to provide vision and hearing screenings at your school, the Illinois Department of Public Health will provide the training to interested parties. Training dates and applications are available by contacting IDPH at 217-782-4733.
*with the exception of Evanston, Oak Park, Skokie, and Stickney Township
