Health Forms

Please find links for Genesis Innovation Academy Student Health Services forms below.

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Important Scholar Health Information

  • Genesis should be informed if your child has a medical condition or chronic illness, requires assistance with medication, or for any medical procedure or treatment.
  • When possible, medication should be taken at home, including all non-essential medications such as vitamins, herbals, essential oils, and narcotic pain medications. However, if medication must be taken at school, on a field trip or during a “before or after” school chaperoned activity, parents must provide all medications (prescribed and over-the counter) in accordance with Genesis Innovation Academy’s Policy.
  • The parent/legal guardian must complete an authorization and instruction form entitled “AUTHORIZATION TO GIVE MEDICATION AT SCHOOL Form”. For all prescription medications, a healthcare provider must also sign the form. The school cannot give medications without the authorization form. The same form is used for prescription and non-prescription medications. Medication Authorization Forms are valid for one/current school year. A separate form MUST be used for each medication.
  • If your child has a medical condition such as asthma, a severe allergy or another health-related condition that requires self-administration of medication, or needs to carry an emergency medication (EpiPen, Diastat, Inhaler, Glucagon, etc.), or has an approved legitimate reason to carry a medication on his/her person, you must complete and submit to the school clinic an "Authorization for Scholars to Carry Medication Form". This form must be signed by the healthcare provider, parent, and scholar.
  • It is the parent or legal guardian’s responsibility to keep the scholar’s health and contact information (telephone numbers, address, etc.) updated.
  • By working together, we can strive to ensure the health and well-being of every scholar so that he/she can benefit from the education program.

Allergy Health Care Plan

Additional text for form could go here. 

Asthma Action Plan

Authorization to Give Medication at School

This form must be completed if medication has to be administered during school hours, on field trips or during a school chaperoned “before” or “after” school activity.

Authorization for Scholars to Carry a Prescription Inhaler, Epinephrine, Insulin, or Other Approved Medication*

Diabetic Medical Management Plan

Genesis Immunization Requirements

Georgia Immunization Requirements for Child Care & School Attendance

Sickle Cell Health Care Plan