Please scroll through your entry and look for missing items that are required.
Every Presbyterian Day School student must have emergency information on file with the school. The school is collecting the following online: Emergency Info, Permission to Treat, Allergy Info, School-Provided Over-the-Counter Medicine Permission.
PDS follows the Tennessee Department of Health Rules for Immunization. All students must have an up-to-date Tennessee Certificate of Immunization to attend school.
The state’s immunization schedule follows the current schedule published by the Centers for Disease Control and Prevention (CDC) and endorsed by the American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP).
This link provides all of the detail on immunization requirements:
Please either upload a scanned copy of your son's immunization record, email it to the nurse, mail it to the school, or drop-off a copy at the school.
Instructions for Scanning : iOS | Android
If you have questions about immunization, please contact the school nurse:
Alice Ball, RN, BSN | | email@example.com 901–842–4627
PDS also requires a written statement from your son’s physician stating that he can participate in physical education and all activities at school.
The nurse accepts any type of physical form (school, camp, generic). A simple note (cleared for all activities, PE & sports) signed by your son's doctor, or a checked box indicating "Date of Physical Exam" on your son's immunization form are also accepted. All forms/notes must be dated and be within a calendar year from the start of school.
If you have your letter, you may upload a scan below, otherwise please either email it to the nurse, mail it to the school, or drop it off with the Admission office.
Please list any food, drug or environmental allergies and indicate their severity and treatment.
All students with an epipen must have an Allergy Action Plan signed by their doctor on file with the nurse.
Please list any restrictions and acute or chronic medical conditions in the space provided below for your child. Examples include bee sting reactions, asthma, epilepsy/seizures, migraines, diabetes, heart condition, any organ condition, musculoskeletal condition, ADHD, and any other medical conditions that are important for the nurse to know.
I give PDS permission to administer the following over-the-counter medications to my son as his condition indicates.
(Please check the medications that you want your son to receive):
I hereby give my permission for Presbyterian Day School to obtain the services of any of the indicated physicians or hospitals in case the above named student suffers illness or accident. In the event that a parent, guardian, or emergency contact cannot be contacted, I authorize school officials to take whatever action is considered to be in the best interest of my child. (Please choose yes or no.)
Public Chapter 148, effective January 1, 2014, requires that school and community organizations sponsoring youth athletic activities establish guidelines to inform and educate coaches, youth athletes and other adults involved in youth athletics about the nature, risk and symptoms of concussion/head injury.
A concussion is a type of traumatic brain injury that changes the way the brain normally works. A concussion is caused by a bump, blow or jolt to the head or body that causes the head and brain to move rapidly back and forth. Even a “ding,” “getting your bell rung” or what seems to be a mild bump or blow to the head can be serious.
Did You Know?
WHAT ARE THE SIGNS AND SYMPTOMS OF CONCUSSION?
Signs and symptoms of concussion can show up right after the injury or may not appear or be noticed until days or weeks after the injury.
If an athlete reports one or more symptoms of concussion listed below after a bump, blow or jolt to the head or body, s/he should be kept out of play the day of the injury and until a health care provider (a Tennessee licensed medical doctor, osteopathic physician or a clinical neuropsychologist with concussion training) says s/he is symptom-free and it’s OK to return to play.
CONCUSSION DANGER SIGNS
In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull. An athlete should receive immediate medical attention after a bump, blow or jolt to the head or body if s/he exhibits any of the following danger signs:
WHY SHOULD AN ATHLETE REPORT HIS OR HER SYMPTOMS?
If an athlete has a concussion, his/her brain needs time to heal. While an athlete’s brain is still healing, s/he is much more likely to have another concussion. Repeat concussions can increase the time it takes to recover. In rare cases, repeat concussions in young athletes can result in brain swelling or permanent damage to their brains. They can even be fatal.
WHAT SHOULD YOU DO IF YOU THINK YOUR ATHLETE HAS A CONCUSSION?
If you suspect that an athlete has a concussion, remove the athlete from play and seek medical attention. Do not try to judge the severity of the injury yourself. Keep the athlete out of play the day of the injury and until a health care provider (a Tennessee licensed medical doctor, osteopathic physician or a clinical neuropsychologist with concussion training) says s/he is symptom-free and it’s OK to return to play.
Rest is key to helping an athlete recover from a concussion. Exercising or activities that involve a lot of concentration such as studying, working on the computer or playing video games may cause concussion symptoms to reappear or get worse. After a concussion, returning to sports and school is a gradual process that should be carefully managed and monitored by a health care professional.
What is sudden cardiac arrest?
Sudden cardiac arrest (SCA) is when the heart stops beating, suddenly and unexpectedly. When this happens, blood stops flowing to the brain and other vital organs. SCA doesn’t just happen to adults; it takes the lives of students, too. However, the causes of sudden cardiac arrest in students and adults can be different. A youth athlete’s SCA will likely result from an inherited condition, while an adult’s SCA may be caused by either inherited or lifestyle issues. SCA is NOT a heart attack. A heart attack may cause SCA, but they are not the same. A heart attack is caused by a blockage that stops the flow of blood to the heart. SCA is a malfunction in the heart’s electrical system, causing the heart to suddenly stop beating.
How common is sudden cardiac arrest in the United States?
SCA is the #1 cause of death for adults in this country. There are about 300,000 cardiac arrests outside hospitals each year. About 2,000 patients under 25 die of SCA each year. It is the #1 cause of death for student athletes.
Are there warning signs?
Although SCA happens unexpectedly, some people may have signs or symptoms, such as:
These symptoms can be unclear in athletes, since people often confuse these warning signs with physical exhaustion. SCA can be prevented if the underlying causes can be diagnosed and treated.
What are the risks of practicing or playing after experiencing these symptoms?
There are risks associated with continuing to practice or play after experiencing these symptoms. When the heart stops, so does the blood that flows to the brain and other vital organs. Death or permanent brain damage can occur in just a few minutes. Most people who experience SCA die from it.
Public Chapter 325 – the Sudden Cardiac Arrest Prevention Act
The act is intended to keep youth athletes safe while practicing or playing. The requirements of the act are:
My electronic signature signifies that the information provided in this document is accurate and that I have provided information, consent, authorization or agreement where indicated.
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