The North Carolina Department of Juvenile Justice and Delinquency Prevention
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Services by County
   
   
North Carolina Government At Your Service
 
Departmental Policies

  Medical Policies
acrobat document YD/YC 3.10 Drug and Alcohol Screening
acrobat document
 YD/YC 5.1 Health Authority
acrobat document YD/YC 5.2 Health Delivery System Reporting
acrobat document YD/YC 5.3 Administration of Treatment
acrobat document YD/YC 5.4 Health Care Specialist
acrobat document YD/YC 5.5 Medical Personnel and Facilities
acrobat document YD/YC 5.6 First Aid Kits
acrobat document YD/YC 5.7 Reporting Communicable Diseases
acrobat document YD/YC 5.7.1 Human Immunodeficiency Virus (HIV)
 & Acquired Immune Deficiency Syndrome (AIDS)
acrobat document YD/YC 5.7.2 Hepatitis B Virus
acrobat document YD/YC 5.7.3 Control Measures for Communicable Disease
acrobat document YD/YC 5.8 Communication of Medical Information
acrobat document YD/YC 5.9 Admissions
acrobat document YD/YC 5.10 Access to Health Care
acrobat document YD/YC 5.11 Non-Emergency Sick Call
acrobat document YD/YC 5.12 Medical Emergencies: Emergency Plan
acrobat document YD/YC 5.12.1 Notification of Parent/Legal Guardian
of Juvenile Medical Emergency or Death
acrobat document YD/YC 5.13 Medications
acrobat document YD/YC 5.13.1 Medications: EpiPen Auto-Injector (Administration)
acrobat document YD/YC Post-Test EpiPen Auto Injector Post-Test
(Gauge Policy Knowledge Base After Training)
acrobat document YD/YC 5.13.2 Psychotropic Drugs and Drugs Requiring Parenteral Administration
acrobat document YD/YC 5.13.3 Staff Training for Administering Medications
acrobat document
 YD/YC 5.13.4 Universal Childhood Vaccine Distribution Program
acrobat document YD/YC 5.13.5 Controlled Substances
acrobat document YD/YC 5.14 Medical Records
acrobat document YD/YC 5.15 Obtaining Consent for Medical Treatment
acrobat document YD/YC 5.16 Pregnancy
acrobat document YD/YC 5.17 Prohibition of Medical Experimentation
acrobat document YD/YC 5.18 Health Trained Staff
acrobat document YD/YC 5.19 Urine Drug Screening
acrobat document Youth Development Center Medical Policy Definitions
   
  Medical Forms
word document
 YC/M 001 Admission History and Physical Examination
word document YC/M 002 Monthly Medical Record Review
word document YC/M 003 Intake Health Assessment (for males) (Enter-Friendly)
word document YC/M 004 Intake Health Assessment (for females (Enter-Friendly)
acrobat document YC/M 005 Juvenile Access to Medical Services - Sick Call
acrobat document YC/M 008 was replaced by YD/M 001,
Medical Screening Interview
word document YC/M 011 Nurses' Notes (Enter-Friendly)
word document YC/M 012 Health Care Provider's Medical Orders (Enter-Friendly)
word document YC/M 014 Record of Medication Administered by Staff (Enter-Friendly)
word document YC/M 017 Special Dietary Request (Enter-Friendly)
acrobat document YC/M 018 Diabetic Record
acrobat document YD/M 019 Body Check Injury Verification
acrobat document YD/M 019A Injury Verification and Instruction (Enter-Friendly) (Created April 2010)
acrobat document YC/M 020 Controlled Substance Inventory
acrobat document YC/M 021 Needle Inventory
word document YC/M 022 Sharps Inventory (Enter-Friendly)
acrobat document
 YC/M 023 First Aid Kit Inventory Replaced by Form YD/M 003
acrobat document YC/M 024 Medical Services Information
acrobat document YC/M 025 Permission for Release of Patient Information
acrobat document YC/M 026 Insurance Authorization
word document YC/M 027 Medical Discharge Summary (Enter-Friendly)
acrobat document YC/M 028 Release Pregnant Delinquent Female
acrobat document YC/M 029 Health Care Statistics
word document YC/M 030 Communicable Disease Statistical Report (Enter-Friendly)
word document YC/M 032 Pregnant Juvenile Report (Enter-Friendly)
acrobat document YC/M 036 Nursing Orientation
acrobat document YC/M 037 Request for An Appointment With A Nurse Form
acrobat document YC/M 037a Request for An Appointment With A Nurse
word document YC/M 038 Camp Woodson Medical and Physical Examination
 (Enter-Friendly)
word document YC/M 041 Juveniles on Psychotropic Medications (Enter-Friendly)
word document YC/M 044 Physicians' Progress Notes (Enter-Friendly)
word document YC/M 044b Psychiatric Screening and Assessment
acrobat document YC/M 047 Record of Hours Worked
word document YC/M 050 Health Care Transfer Summary (Enter-Friendly)
word document YC/M 051 Request for Urine Drug Screening and Test Results
(Enter-Friendly)
word document YC/M 052 Nursing Report to Service Planning Team (Enter-Friendly)
word document YC/M 054 Medication Administration Error Report (Enter-Friendly)
acrobat document YC/M 055 Plan of Corrective Action for
Medication Administration Error
word document YC/M 056 Medication Error Summary Report
acrobat document YC/M 058 Alcohol Test Results
word document YC/M 059 Drug and Alcohol Test Results Monthly Report (Enter-Friendly)
acrobat document YC/M Chart I Two-Step Tuberculin Skin Testing
acrobat document YC/M SD009 Youth Development Training Course Record
acrobat document YC/M 100 Parent and/or Guardian Information
on Antianxiety Medications Form
acrobat document YC/M 150 Cardiac Science Powerheart AED Daily Maintenance
acrobat document YC/M 151 Cardiac Science Powerheart AED Monthly Maintenance
acrobat document YC/M 152 Cardiac Science Powerheart AED Annual Maintenance
acrobat document YD M 001 Medical Screening Interview (Enter-Friendly)
word document YD/M 002, Juvenile Medical Alert (Enter-Friendly)
word document YD/M 003, First Aid Kit Inventory (Enter-Friendly)
acrobat document YD/M 004 What Every Juvenile Should Know About HIV/AIDS (Re-numbered from YC/M 006)
acrobat document YD/M 005 Verification of Providing and Discussing with Juvenile What Every Juvenile Should Know about HIV/AIDS (Re-numbered from YC/M 007)
acrobat document YD/M 006 Verification of Counseling for Policy 12.12.2 HIV/AIDS (Re-numbered from YC/M 034)
acrobat document YD/M 007 Verification of Counseling for Policy 12.12.3 Hepatitis B (Re-numbered from YC/M 035)
word document YD/M 008 Four Minute Response Drill Report (Re-numbered from YC/M 053)
acrobat document YD/M 009 Health Care Provider's Sign In Sheet (Re-numbered from YC/M 048)
word document YD/M 010 Admission and Release Body Check Verification (May 2011) (Re-numbered from DC/M 002)
   
acrobat document  YD/M 100 Parent and/or Guardian Information on Alprazolam (Xanax, Intensol, Viravam) Form
acrobat document  YD/M 101 Parent and/or Guardian Information on Amphetamine Form
acrobat document  YD/M 102 Parent and/or Guardian Information on Aripiprazole (Abilify) Form
acrobat document  YD/M 103 Parent and/or Guardian Information on Atenolol (Tenormin) Form
acrobat document  YD/M 104 Parent and/or Guardian Information on Atomoxetine (Strattera) Form
acrobat document  YD/M 105 Parent and/or Guardian Information on Benztropine (Cogentin) Form
acrobat document  YD/M 106 Parent and/or Guardian Information on Bupropion (Wellbutrin, Budeprion) Form
acrobat document  YD/M 107 Parent and/or Guardian Information on Buspirone (BuSpar) Form
acrobat document  YD/M 108 Parent and/or Guardian Information on Carbamezapine (Tegretol, Carbatol)Form
acrobat document  YD/M 109 Parent and/or Guardian Information on Clorpromazine (Thorazine, Ormazine)Form
acrobat document  YD/M 110 Parent and/or Guardian Information on Citalopram (Celexa) Form
acrobat document  YD/M 111 Parent and/or Guardian Information on Clomipramine (Anafranil) Form
acrobat document  YD/M 112 Parent and/or Guardian Information on Clonazepam (Klonopin) Form
acrobat document  YD/M 113 Parent and/or Guardian Information on Clonidine (Catapres) Form
acrobat document  YD/M 114 Parent and/or Guardian Information on Clozapine (Clozaril, FazaClo) Form
acrobat document  YD/M 115 Parent and/or Guardian Information on Cyproheptadine (Periactin) Form
acrobat document  YD/M 116 Parent and/or Guardian Information on Desipramine (Norpramin) Form
acrobat document  YD/M 117 Parent and/or Guardian Information on Desmopressin (DDAVP, Stimate) Form
acrobat document  YD/M 118 Parent and/or Guardian Information on Diazepam (Valium) Form
acrobat document  YD/M 119 Parent and/or Guardian Information on Diphenhydramine (Benadryl) Form
acrobat document  YD/M 120 Parent and/or Guardian Information on Duloxetine (Cymbalta) Form
acrobat document  YD/M 121 Parent and/or Guardian Information on Escitalopram (Lexapro) Form
acrobat document  YD/M 122 Parent and/or Guardian Information on Estazolam (ProSom) Form
acrobat document  YD/M 123 Parent and/or Guardian Information on Eszopiclone (Lunesta)Form
acrobat document  YD/M 124 Parent and/or Guardian Information on Fluoxetine (Prozac) Form
acrobat document  YD/M 125 Parent and/or Guardian Information on Fluphenazine (Prolixin) Form
acrobat document  YD/M 126 Parent and/or Guardian Information on Flurazepam (Dalmane) Form
acrobat document  YD/M 127 Parent and/or Guardian Information on (Fluvoxamine (Luvox)Form
acrobat document  YD/M 128 Parent and/or Guardian Information on Gabapentin (Neurotin) Form
acrobat document  YD/M 129 Parent and/or Guardian Information on Guanfacine (Tenex) Form
acrobat document  YD/M 130 Parent and/or Guardian Information on Haloperidol (Haldol)Form
acrobat document  YD/M 131 Parent and/or Guardian Information on Hydroxyzine (Atarax, Vistaril) Form
acrobat document  YD/M 132 Parent and/or Guardian Information on Imapramine (Tofranil) Form
acrobat document  YD/M 133 Parent and/or Guardian Information on Lamotrigine (Lamictal) Form
acrobat document  YD/M 134 Parent and/or Guardian Information on Lithium (Eskalith, Lithobid) Form
acrobat document  YD/M 135 Parent and/or Guardian Information on Lorazepam (Atavan) Form
acrobat document  YD/M 136 Parent and/or Guardian Information on Loxapine (Loxitane) Form
acrobat document  YD/M 137 Parent and/or Guardian Information on Melatonin Form
acrobat document  YD/M 138 Parent and/or Guardian Information on Methylphenidate (Methylin, Ritalin, Metadate, Concerta) Form
acrobat document  YD/M 139 Parent and/or Guardian Information on Mirtazapine (Remeron) Form
acrobat document  YD/M 140 Parent and/or Guardian Information on Modafinil (Provogil) Form
acrobat document  YD/M 141 Parent and/or Guardian Information on Nortriptyline (Pamelor) Form
acrobat document  YD/M 142 Parent and/or Guardian Information on Olanzapine (Zyprexa) Form
acrobat document  YD/M 143 Parent and/or Guardian Information on Oxcarbazepine (Trileptal) Form
acrobat document  YD/M 144 Parent and/or Guardian Information on Paroxetine (Paxil, Paxeva) Form
acrobat document  YD/M 145 Parent and/or Guardian Information on Perphanezine (Trilafon) Form
acrobat document  YD/M 146 Parent and/or Guardian Information on Pimozide (Orap) Form
acrobat document  YD/M 147 Parent and/or Guardian Information on Pindolol (Visken) Form
acrobat document  YD/M 148 Parent and/or Guardian Information on Propranolol (Inderal) Form
acrobat document  YD/M 149 Parent and/or Guardian Information on Quetiapine (Seroquel) Form
acrobat document  YD/M 153 Parent and/or Guardian Information on Temazepam (Restoril) Form
acrobat document  YD/M 154 Parent and/or Guardian Information on Thiothixene (Navane) Form
acrobat document  YD/M 155 Parent and/or Guardian Information on Topiramate (Topamax) Form
acrobat document  YD/M 156 Parent and/or Guardian Information on Trazodone (Desyrel) Form
acrobat document  YD/M 157 Parent and/or Guardian Information on Triazolam (Halcion) Form
acrobat document  YD/M 158 Parent and/or Guardian Information on Trifluoperazine (Stelazine) Form
acrobat document  YD/M 159 Parent and/or Guardian Information on Valproic Acid (Depakene) and Divalproex Sodium(Depakote) Form
acrobat document  YD/M 160 Parent and/or Guardian Information on Venlafaxine (Effexor) Form
acrobat document  YD/M 161 Parent and/or Guardian Information on Zaleplon (Sonata) Form
acrobat document  YD/M 162 Parent and/or Guardian Information on Ziprasidone (Geodon) Form
acrobat document  YD/M 163 Parent and/or Guardian Information on Zolpidem (Ambien) Form 
   
  Other Forms
acrobat document
 Youth Development Health Care Policy Statement of Understanding Attachment
acrobat document YC/M 106 Report of Theft or Loss of Controlled Substance
acrobat document YC/M 226 Application for Reregistration
acrobat document YC/M 3405 TB Screening Form
acrobat document YC/M 3974 Wasted Expired Vaccine Form
acrobat document YC/M 4041 Vaccine Administration Record
acrobat document YC/M 2124 Communicable Disease Card Instructions
acrobat document Exceptional Children Procedures
acrobat document Frozen Vaccines Temperature Storage Log
acrobat document VAL116 Vaccines Administered Log
acrobat document Refrigerated Vaccines Temperature Log
acrobat document Diptheria, Tetanus and Pertussus Vaccines Information Sheet
acrobat document Hepatitis B Vaccine Information Sheet
acrobat document Mumps, Measles and Rubella Vaccine Information Sheet
acrobat document Characteristics and Content DMM Issue
   


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