STEP 2. Student Health Form

 
How DeKalb County School System and D.A.T.E Administer Medications
 
  • The term “medication” means all legal substances including but not limited to prescription drugs, over-the-counter drugs, inhalants, pills, tablets, capsules, herbal medications, and all other legal drugs.
  • Any student required to take medication while at school must have a written authorization by the parent/guardian and physician.
  • Prescription medications must be properly labeled by a pharmacist and in the original container.
  • Non-prescription medication must be in the original container.
  • All medications must be personally delivered to the school nurse, Ms. Franklin, with a  Physician's Authorization to Administer Medication G9 - 2018-19.pdf    to Ms. Franklin here.
  • These procedures must be followed to avoid charges of negligence.
 
DeKalb County School System
PHYSICIAN’S REQUEST FOR ADMINISTRATION OF MEDICATION AT SCHOOL BUILDING DURING SCHOOL HOURS
 
1. To keep this child in optional health and to help maintain school performance, it is necessary that medication be given during school hours.
2. Nurses and other designated school personnel can assist with self-administration of medication during school hours.
3. In order for medication to be self administered at school, this form must be completed by licensed physician and at least one guardian/parent and be returned to school
 4. One form must be completed by a licensed physician and at least one guardian/parent for each prescription or non-prescription medication that is to be administered during school hours.
 5. Download a printable copy of the  Administer Medication G9 - 2018-19.pdf . You must have this form signed by a doctor. You can type into the form and print before taking to your doctor.

 

 

 


 

 

STEP 3. Photo Release Form

This form gives permission to The Academy for my child to be photographed and/or interviewed by The Media/Social Media DURING THEIR TENURE AT THE SCHOOL for the purpose of:
 
1. PROMOTING SCHOOL ACTIVITY
 
I understand that this photograph and/or interview will be used for no other purpose than the one stated above.
 
 

 

STEP 4. Field Trip Consent

 
 
I, the undersigned parent or guardian, hereby consent to my child participating in any/all events sponsored by DeKalb Academy of Technology and The Environment, Inc. I certify that my child is able to participate in all the activities of this event. If my child has medical conditions which may be relevant to a physician in the event of an emergency, I have listed them below. In the event an emergency occurs, I may be reached at the telephone number listed below. I hereby authorize a DeKalb Academy employee or designate to make emergency medical decisions for my child. If there are any activities I do not want my child to be involved in, I have listed them below. I UNDERSTAND AND HEREBY AGREE TO ASSUME ALL RISK WHICH MAY BE ENCOUNTERED ON SAID ACTIVITY, INCLUDING ACTIVITIES PRELIMINARY
AND SUBSEQUENT THERETO. I do hereby agree to hold DeKalb Academy of Technology and The Environment, Inc. and its agents and employees, harmless from any and all liability, actions, causes of actions, claims, expenses, and damages on account of injury to my child or property, even injury resulting in death, which I now have or which may arise in the future in connection with the activity or participation in any other associated activities.
 
I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted by the law of the State of Georgia and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between parties hereto and the terms of this release are contractual and not a mere recital. I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. This is a legal binding agreement which I have read and understand.
 

STEP 5. Needs Assessment

Click here to complete the Needs Assessment form in a new window.

(Be sure to close after submitting to come back to our site)

 

In order to provide the most effective programs to prevent and reduce problems such as drug abuse and violence surveys are periodically given to students to assess their exposure to these problems. The Georgia Department of Education has developed a “Needs Assessment” that will be administered statewide during the month of January each year. The questionnaires are totally anonymous and take no more than 15 minutes to complete. The data collected is used to identify critical areas needed to establish Safe and Drug-Free Schools in DeKalb County.

Our desire is to involve parents in the education of their children, for this reason we ask that you complete and sign this form. Your child will be allowed to participate in this important activity only if this form is completed and returned to the school with the application package.
Our main goal in the Safe and Drug-Free Schools program are to:
  • Assist in maintaining a school environment that is free of drugs and violence.
  • Promote a class atmosphere that allows teachers to teach and students to learn.
  • Develop and offer experiences that involve students in applying the concepts of making healthy decisions, accepting responsibility for their behavior, and understanding consequences.
  • Seek ongoing funding to address problem areas, such as, violence, drug abuse and school failure.

 

ADDITIONAL FORMS

Click to download, fill and sign Physician's Authorization to Administer Medication - G9.pdf 

How DeKalb County School System and D.A.T.E Administer Medications
 
  • The term “medication” means all legal substances including but not limited to prescription drugs, over-the-counter drugs, inhalants, pills, tablets, capsules, herbal medications, and all other legal drugs.
  • Any student required to take medication while at school must have a written authorization by the parent/guardian and physician.
  • Prescription medications must be properly labeled by a pharmacist and in the original container.
  • Non-prescription medication must be in the original container.
  • All medications must be personally delivered to the school nurse, Ms. Franklin, with a  Physician's Authorization to Administer Medication G9 - 2018-19.pdf    to Ms. Franklin here.
  • These procedures must be followed to avoid charges of negligence.
 
DeKalb County School System
PHYSICIAN’S REQUEST FOR ADMINISTRATION OF MEDICATION AT SCHOOL BUILDING DURING SCHOOL HOURS
 
1. To keep this child in optional health and to help maintain school performance, it is necessary that medication be given during school hours.
2. Nurses and other designated school personnel can assist with self-administration of medication during school hours.
3. In order for medication to be self administered at school, this form must be completed by licensed physician and at least one guardian/parent and be returned to school
 4. One form must be completed by a licensed physician and at least one guardian/parent for each prescription or non-prescription medication that is to be administered during school hours.
 5. Download a printable copy of the  Administer Medication G9 - 2018-19.pdf . You must have this form signed by a doctor. You can type into the form and print before taking to your doctor.