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Hassan H. Youssef, MD SC
400 South Kennedy Drive
Bradley, IL 60915

Tel:  +1 815-932-3132
Fax: +1 815-932-2397

dryoussefandstaff.com


 

Patient Resources

School Physicals
Vitals with all- Height, Weight, BP, Pulse Growth Charts, BMI calculated, Diabetes Screening

Pre-K (3-4 yrs)

Illinois DHS Form
Lead/HBG/TB/UA
DTap, MMR, IPV, Varicella

Kindergarten (5yrs)

Illinois DHS Form
UA
Above shots if not given at age 4

6th Grade (10-11yrs)

Illinois DHS Form (No Sports form needed)
UA
Adacell (11yr), Menactra (age 2 up), Varicella #2
Gardisil recommended but not with Menactra

7-8th Sports

Illinois Elementary School Assn. Form
UA
Check Adacell, Menactra, Gardisil, Varicella#2

9th Grade/ H.S.

Illinois DHS Form (No IHSA sports form)
UA
Adacell, Menactra,Varicella
Gardisil recommended but not with Menactra

10-12th Sports

IHSA Sports Form
UA
Check Menactra, Gardisil

Nurses: Please collect UA here or if time allows, write scripts for labs needed at other facilities. Attaching Quest forms always helps.
 

 
   
 

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