Skip survey header

2022-23 School Health Services Resources

Thank you for your assistance in consistently sharing your data with the Division of Child and Family Well-Being related to health services provided in your district. This information is used to assist with local school health program development, to inform stakeholders in school health who work with student issues, and to describe school health services that are provided by school nurses across the state. Copies of past summary reports are available on the School Nursing Support webpage.

Most questions related to report forms should be addressed through review of the related Definitions and Directions. Any remaining questions may be directed to Jenifer.Simone@dhhs.nc.gov  Assistance in completing the forms may be obtained from your Regional School Health Nurse Consultant.

A preparation worksheet is provided for each report form. Download the worksheets and mark the appropriate response before beginning the online report survey. For Staffing Form A and Screening Form B, download the Excel spreadsheet, enter your local information, and save it to your computer. Attaching the document from a cloud-based account, i.e., Google Drive, is not an allowable function. You will be asked to upload the Excel spreadsheet once you begin the online report survey for Staffing Form A and Screening Form B just as you would add an attachment to an email message. You will receive an email confirmation within 24 hours if your report was successfully submitted. Check your spam or junk folders before contacting your regional consultant.

Review and share the Definitions and Directions with ALL school nurses before starting the data collection process this year. The Definitions and Directions (D & D) for the Section One and Section Two reports have been incorporated into the worksheets for convenience.  Separate D & D documents follow each report. A School Health Data Workbook is also available for nurses to collect and tally data by school. This workbook is located at the bottom of the page under Additional Resources. Use of this workbook is optional; but if implemented, ensure data collection entries start at the beginning of each school year. Contact your regional consultant for assistance or further clarification.






 
Section One

Due annually no later than December 1st.

If revisions are needed in June, Section One Revisions will be completed by the Regional Nurse Consultant after submission of the revised Staffing Form A. 

Thank you for completing this survey each school year. The worksheets and forms are in Word® and in Excel® programs. Open each document, and then save it to your computer as it is titled with your district name added to the beginning of the file name. You can begin using these documents at any time.  The forms are available on the School Health Services Resources webpage.

This report is expected from all public-school districts (LEAs) and public charter schools in North Carolina.  A public-school district (LEA) completing this form should not count data from a charter school in their county as charter schools will complete their own reports. Please note that an Excel® School Health Data Workbook is also available under Additional Resources at the bottom of the webpage that provides tools for desktop collection and recording of data by individual school nurses for each school served. 

Most of the reporting form is self-explanatory. Changes since last year are noted and will also be reviewed through the School Health Nurse Consultants. The definitions that follow are to assist you in collecting and reporting the data accurately. In some questions, the choices are listed in a format that asks you to choose one or more or fill in the blank if “other” is chosen.  Please contact your regional consultant for assistance or further clarification as needed. 

We will provide reminders in November and in May.  Contact your Regional School Health Nurse Consultant if your school year ends after June 20th and a revision to Section One will be necessary due to change in the total number of nursing positions. 


Click here for Section One Definitions and Directions

Click here for Section One Worksheet with Integrated D & D
 
Click here to complete the online Section One Survey
 

*Note: Starting on page 2 of the online Section One survey, you will be able to save your work and continue at a later time by clicking on the red Save and Continue bar at the top of the page.

Staffing Form A

Due annually no later than December 1st; revisions due no later than June 20th. 
June Staffing Form A revisions should ONLY be submitted if you have a change in total staffing positions or hours since last submission.

Download the Staffing Form A Excel Worksheet by clicking on the link provided below and save it to your computer. After entering your local information, you must re-save it to your computer keeping the document title (file name) intact and inserting your district name at the beginning of the title.  
Example: BladenStaffing2022-23


Click here for the Staffing Form A Definitions and Directions

Click here for the Staffing Form A Excel Worksheet

After compiling your responses on the Excel Worksheet and saving to your computer according to the instructions above, you will use the link below to ‘upload’ your saved Staffing Form A and submit the report form electronically.

Click here to electronically submit Staffing Form A
Screening Form B

Due Annually no later than June 20th.
Click on the links below to access the Excel Worksheet. Please save the files to your computer before typing on them. Download the Screening Form B Excel Worksheet provided below and save it to your computer. After entering your local information, you must re-save it to your computer keeping the document title (file name) intact and inserting your district name at the beginning of the title.
Example: BurkeScreening2022-23

Click here for the Screening Form B Definitions and Directions

Click here for the Screening Form B Excel Worksheet

After compiling responses to the Excel Worksheet and saving it to your computer according to the instructions above, you will use the link below to ‘upload’ your Excel Worksheet and submit the report form electronically.


Click here to electronically submit Screening Form B

 
Section Two

Due Annually no later than June 20th.

Click on the links below to access the Section Two Worksheets. Please save the files to your computer before typing on them. Please download the LEA Section Two Worksheet with Integrated D & D or Charter School Health Services Report and Section Two Worksheet with Integrated D & D linked below and save it to your computer. Gather your local data and place your responses on the Worksheets to assist when entering the information into the report survey. 

Click here for the LEA Section Two Definitions and Directions

Click here for the LEA Section Two Worksheet with Integrated D & D

Click here for the Charter School Health Services Report and Section Two Definition and Directions

Click here for Charter School Health Services Report and Section Two Worksheet with Integrated D & D

After compiling responses on the Worksheets, click on the LEA Section Two Survey or Charter School Health Services Report and Section Two Survey linked below to submit your responses electronically. It is important to have your responses prior to beginning the report survey.

Click here to complete the LEA Section Two Survey

Click here to complete the Charter-School Health Services Report and Section Two Survey


*Note: Starting on page 2 of the electronic Section Two Surveys, you will be able to save your work and continue at a later time by clicking on the red Save and Continue bar at the top of the page.
Additional Resources

Click here for the School Health Data Workbook

For optional use, this Excel Workbook can be used to collect and tally most individual school nurse data for Section Two. Each type of information is on a separate tab at the bottom.

Click here for the School Health Case Management Tracking Log

For optional use, this Excel Workbook can be used to collect and tally school nurse data related to case management outcomes for Section Two. Each chronic condition is on a separate tab at the bottom.