2019 Scoliosis Screening Form
October, 2019

Dear Parent:

On October 29th scoliosis screening will take place at your child’s middle school to identify children with suspected abnormal curvature of the spine. The screening is done yearly in the middle school grades as required by State Law (O.C.G.A. § 20-2-772), Department of Community Health and State Department of Education guidelines. You may opt out of screening for your student by completing this form.

Scoliosis affects one to two percent of the adolescent population. About two out of every one hundred students have scoliosis. If the condition is detected early and appropriately treated, progressive spine deformity can be prevented.

The procedure for screening is a simple observation test in which the screener (student nurse, physical education teacher or trained volunteer) looks at the child’s back in the standing position and the forward bending position. Boys and girls are screened separately. Your child will be asked to remove their shirt. Girls should wear a sports bra or bathing suit top. Accurate screening cannot be performed if girls are wearing camisoles. If your child presents without the appropriate clothing they will not be screened.

If your child has a suspected abnormal curvature you will be notified by letter from the Gwinnett County Health Department of the results and the need for further follow-up screening either by the Health Department or private physician.

If your child is absent on the day of screening, please contact your local health department or private physician for scoliosis screening.

If you do not want your child to be screened at school you must complete the requested information below by October 15th.

Sincerely,

Lanier Middle School

Version en Español
https://docs.google.com/document/d/1VYuKorFrTs__ytvmXFFK_1yYIOE8C9IPL60wjRdk3hY/edit?usp=sharing
Legal Last Name of Student *
Your answer
Legal First Name of Student *
Your answer
Homeroom Teacher of Student *
Grade of Student *
Required
Birthday of Student *
In the event of students having the same name
MM
/
DD
/
YYYY
I DO NOT WANT MY CHILD SCREENED FOR SCOLIOSIS
YOUR CHILD WILL BE SCREENED IF YOU LEAVE BLANK
Parent Last Name *
Your answer
Parent First Name *
Your answer
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