Health, Wellness and Medical Forms
We want to keep our community healthy. Please use the information below to guide you as you medically prepare your child for school.
Medical History
- Update your child’s medical history in FACTS/RenWeb (District code: at-ga).
- Please contact the School Nurse, Katrina Henley, at khenley@atlantaspeechschool.org to schedule a time to discuss medical concerns that may impact your child’s health and wellness during the academic school day.
Required Medical Forms
Immunizations: All Students must have an updated 3231 Georgia Immunization form (from your pediatrician) or a notarized DPH 2208 Religious Exemption form on file.
- Returning Students: Submit an updated Georgia 3231 form (from your child’s pediatrician) if your child has recently received immunizations
- Returning Students who have a religious exemption on file do not need to update immunization records.
- New Students: Submit an updated Georgia 3231 Immunization Record (from your child’s pediatrician) or a DPH 2208 Religious Exemption form. Please speak to your child’s pediatrician for more information.
Vision, Hearing, Dental and Nutrition Screenings: Students three years of age must have a physician signed-Georgia 3300 form on file (form does not need to be fully completed).
- Returning Students: If you have previously submitted form 3300, resubmission is not required
- New Students: Submit a signed Georgia 3300 for child(ren) three years of age
- Students two years of age: 3300 form is not required.
- Wardlaw students: 3300 form is not required.
COVID-19/Illness Policy: Please refer to the CDC for current protocols.
School Nurse
Plan of Care/Medication
If your child has a medical diagnosis that will require medical intervention during their academic day, a parent- and physician-signed plan of care must be submitted to the School Nurse each academic school year. Please scroll down for care plan forms and follow the steps below.
- Print the care plan(s) applicable to your child’s medical history.
- Have your child’s physician complete and sign the care plan.
- Parent signature is also required.
- Return completed care plan to the School Nurse at khenley@atlantaspeechschool.org.
Below are medical forms you may need for your child, including an allergy action plan, an asthma action plan, a seizure action plan, and a request and consent for medication administration form. Please download or print the appropriate forms, fill them out completely, and submit following the instructions above.
Care Plan Forms:
Allergy Action Plan
Asthma Action Plan
Seizure Action Plan
Request and Consent for Medical Administration
All medical forms including Georgia's Immunization Form 3231 (from pediatrician) and Georgia's Vision, Hearing, Dental and Nutrition Form 3300, as well as any child-specific Medical Care Plans can be turned into Nurse Katrina in the following ways:
Email to: khenley@atlantaspeechschool.org
Mail to: Atlanta Speech School ATTN: Nurse Katrina
3160 Northside Parkway NW
Atlanta, Georgia 30327
Fax: 844.392.0880
Please write the name of the school your child attends in the top right corner of each form you send in.