Medical Policies

The Medication and Illness Policies for Falls Lake Academy

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. You are welcome to go ahead and fill them out and bring them with you then. 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.

Over the counter medicine- we are allowed to hold over the counter medication (FDA approved only) in the nursing office for our students to take when needed. We have specific staff members trained (other than myself) to give medications. Please fill out the Medical Authorization Form (or add to an existing one you have for that child) and bring in a sealed labeled bottle that has directions on it (this includes creams, eye drops, ointments, liquid, lozenges, etc). Siblings are allowed to share over the counter medication but they need separate medication authorization forms and make sure you indicate dosages for each child.

Prescription medicines (pills, liquids, creams, inhalers, Epi pens) are anything that has to be filled by a pharmacy and is labeled for that child. Fill out a Medical Authorization Form (or add to the existing one), bring in a copy of the prescription or have the health care provider write the same information the prescription would have and have them sign it. A new, mandatory form is the Parent/Provider Approval Medication Form which must be filled out for each prescription. Bring the medicine in a labeled bottle or container and I strongly suggest bringing in an extra labeled bottle that we can send field trip medicine in.

If you would like for your child to carry diabetic supplies, epinephrine pens, or inhalers, also fill out a Self-Carry Medication Form (even if they have carried in the past, we need a new one for each school year). I will then review the information before the student can carry the medicine on them. Students are not allowed to carry any other type of medication on them, even on field trips.

If medication is found or sent in by way of your child, it will be taken by the office staff and held in the nursing office until an adult can pick it up. We only allow adults to bring in or pick up any medicine.

Doctors’ offices can also fax us any information at 919-964-9008.

​Please do not hesitate to email the nursing staff with any questions/concerns.


Mara Shelton, RN

​Tracey Ruffin, RN

Forms and Downloads

  • Health Assessment Form
  • Medical History Form (All students must have this form on file)
  • Medication Authorization Form (Students who need to take medication at school must have this form on file)
  • Self-Carry Medication Form (For EpiPens and Inhalers ONLY)


  • Immunization Information

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

7th Grade Shot Requirements

Students must have received the following shots by the 30th day of school if they have turned 12 years old by July 1 or if they are entering 7th Grade, whichever comes first.

  • DTaP (diphtheria, tetanus, and acellular pertussis)
  • Polio
  • Hib (haemophilus influenzae type B)
  • Measles
  • Mumps
  • Rubella
  • Hepatitis B
  • Varicella
  • One dose of Tdap (tetanus, diphtheria, acellular pertussis)
  • One dose of Meningococcal Vaccine

Policies Regarding Concussions

  • ​Concussion Form
  • 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.
  • The 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.

PLEASE REFER TO PAGES 4 AND 6 of the link below to view the Return to Play and Return to Learn paperwork.

Diabetic Forms

  • Quick Reference Emergency Plan Form
  • Diabetes Medical Management Plan Form (DMMP)

The two forms below (which need to be redone every school year) must be turned by the first day of school. Please keep in mind the other forms (med authorization, self-carry, and parent/provider) also need to be filled out as well. 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 student holding on to their own supplies) keeping supplies in the office and spread out in some of the classrooms.

Peanut Allergies

Dear Parents and Guardians,

Every year we have a growing number of students and staff with severe peanut/nut product allergies. These students span EVERY grade level in the school building. We like to treat all classrooms carefully as if there are allergic students in each one, because there is most likely, at least one. Some of these individuals are so allergic and sensitive to peanuts and nut products that touching surfaces after nut products have been there or even dust from the nut products in the area can cause them to have a severe reaction (anaphylaxis) and stop breathing. If your child consumes peanut/nut products during school, their hands MUST be washed immediately after with soap and water as well as the surface the food touches. Falls Lake Academy prefers nut products not be sent in at all, but if they are, your child may be moved to another area of the classroom to eat to avoid allergic reactions.

All food brought in for the class must be store-bought and sealed, with ingredients listed on the package. We prefer all products being brought for the whole class to be peanut-free. Let your teacher know ahead of time if you plan on bringing in food so we can make adjustments for any child with special dietary needs. This way they are not left out of any classroom festivities. Please also talk to your child about the importance of not sharing food with other children.

Please keep the schools safe for these individuals and be aware of food being sent in. Allergies like these typically worsen over time and exposure. We need to limit this as much as possible and your help is greatly appreciated. In the event of an allergic reaction taking place, our staff is prepared and trained in anaphylactic shock and how to best care for your child.