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Health Services

Medication Administration Policy

Our school has a policy to assure the safe administration of medication to students during the school day.  If your child must have medication of any type given during school hours, including over-the-counter medicine, you have the following choices:

  • Parent/Guardian or designated adult may come to school and give the medication to your child at the appropriate time/when needed.

  • Parent/Guardian may obtain a medication authorization form from the school nurse or FLA website. This form needs to be completed by the prescribing physician each school year for prescription medications as well as over the counter medications.  Over the counter medications would include but not limited to cough drops, hydrocortisone cream, Neosporin, Tylenol, Motrin for example.  This form needs to include prescribed medication, dosage, and time to be administered.  The form must be signed by prescribed physicians or licensed personnel as well as signed by parent/guardian.  Prescription medicine must be brought to school by parent/guardian in pharmacy labeled bottle. Over the counter medication must also be brought in by parent/guardian in an unopened container labeled with student name. Siblings may share over the counter medications but must have a separate medication authorization form completed by physician for each student.

  • If your student will be attending a school sponsored overnight or extended field trip without a parental chaperone and will need any medication (prescribed or OTC)  while on trip then a medication authorization form must be completed as well. This form must be completed and returned to the school nurse at least one week prior to the field trip along with the required medication. 

  • Parent/Guardian may discuss with your student’s physician an alternative schedule for administering medication (i.e. outside of school hours or school sponsored activities).

Note there may be times medication is administered by trained staff personnel other than the school nurse.  No school personnel will administer any medication to students unless they have received a completed medication authorization form. At no time can a student carry any medication with them at school or school sponsored events such as field trips for safety purposes unless a self-carry form for emergency type medications has been completed by physician, parent and student. Medications should be stored in the nursing office.   In fairness to those giving the medication and to protect the safety of your student there will be NO EXCEPTIONS TO THIS POLICY.




Falls Lake Academy, the Center for Disease Control, and our state health policies support being active in getting vaccinations.  Please read the link below for information on diseases and their vaccine.  I have listed those required and recommended.  If you have chosen not to give your child vaccines for medical or religious reasons, please email me and let me know immediately.  Keep in mind that we do have several children with compromised immune systems that these diseases can have a deadly effect on.

Required Immunizations

Immunization Exemptions



Medical History 

The Medical History Form is mandatory and must be filled out completely for each student.  They are included in the packet you receive at open house.  As the student’s guardian, you are responsible for giving Falls Lake Academy all the child’s health information so we can better care for your child.




Diabetic Information 

The two forms below (which need to be redone every school year) must be turned by the first day of school.  Please send in glucagon so we can care for your child in the case of an emergency.  If your child is a diabetic who is new to the school, please email one of our nurses at or so we can set up a meeting and discuss a care plan prior to school starting.  I recommend (on top of the students holding on to their own supplies) keeping supplies in the office and spread out in some of the classrooms. 

Diabetes Medical Management Plan Form (DMMP)





  • It is the guardian's responsibility to report any concussions/head injuries that occur outside of Falls Lake Academy.  There will be a place on the Medical History Form to document any concussions that have happened previous to the start of this school year.  If a concussion does occur outside of school, please email or call the front office, if you choose to email, please include one of our nurses at or  I will then pass along the information to all those that care for your child.

  • We keep a list of the reported concussions for a year after the date of the injury.  Staff will be aware of these students in case of repeated concussions or if any symptoms may once again occur.

  • Staff of Falls Lake Academy have been trained in signs and symptoms of a concussion and plan of action if one were to occur during school activities/athletics.  The student will stop whatever activity they are doing and be assessed by the appropriate staff available at the time.

  • Guardians will be contacted if a concussion/head injury occurs and will also be educated of signs and symptoms of a concussion.
  • If a concussion continues to interfere with academics, a team will meet regarding working with the student to better meet their needs.  The team consists of the nurse, teacher, principal, guidance counselor, and other appropriate administrative staff.



Please seek medical attention! We strongly suggest that the student be seen by a medical professional if any evidence suggests a concussion.  If the guardian chooses not to seek medical attention (against the advice of the school), before the student returns to school, the guardian must sign the appropriate form from the office.  This form states that the student has been symptom free for over 24 hours, that the guardian chose not to receive medical care for the student, and that the guardian is liable for any issues related to that head injury that may occur under the care of Falls Lake Academy.



  • If the child is a school athlete, it is mandatory that a plan (return to play plan) be initiated and given to the athletic director.  This plan eases the child's way back into physical activity safely.

  • If the child is not a school athlete, it is very strongly recommended that a return to play and return to learn form be filled out by a medical provider.  These forms (standard forms for North Carolina) let us know the limitations for the child upon returning to school.  We will follow the guidelines of the most current form until an updated one is given to us or the student has been medically cleared (we also need documentation of this).  The student cannot attend school field trips until they have been medically cleared also.


If the student is medically diagnosed with a concussion and brings no paperwork to school, the guardian will be called to pick the student up.  We MUST have some sort of paperwork that lets the school know how to handle the student's injury before they can return to school.

Concussion Form

Epinephrine Pens

Epi Pen Plan

Emergency Care Plan



Forms and Downloads

NC Health Assessment Form

Medication Authorization Form

Diabetes Medical Management Plan Forms

Medical History Form

Concussion Management Form


Immunization Requirements


7th Grade

12th Grade


Peanut Allergies


Forms can be faxed to 919-964-9008

Attn: School Nurse