Our dress code is designed to provide families with flexible options that can be purchased at a location of your choice.
- Shirt Colors Choices: Turquoise, Kelly Green, Navy Blue, and White
- Slacks: Khaki or Navy
- Skirts: Khaki or Navy
- Jumpers: Khaki or Navy
Order the spirit wear, and polos, online at our online store
Medication Permission Form:
Notice of Non-discrimination
Brookhaven Innovation Academy does not discriminate on the basis of race, color, national origin, sex, disability, or age in its programs and activities and provides equal access to the Boy Scouts and other designated youth groups.The following person has been designated to handle inquiries regarding the non-discrimination policies:
Ms. Julie Tolbert, Head of School
182 Hunter Street
Norcross, GA 30071
For further information on notice of non-discrimination, visit http://wdcrobcolp01.ed.gov/CFAPPS/OCR/contactus.cfm for the address and phone number of the office that serves your area, or call 1-800-421-3481.
Asbestos Hazard Emergency Response Act
The Asbestos Hazard Emergency Response Act (AHERA) requires school districts to inspect their buildings for asbestos-containing building materials and develop, maintain, and update an asbestos management plan. School districts must annually notify parents, teachers, and employee organizations in writing of the availability of the management plan and planned or in progress inspections, re-inspections, response actions, and post- response actions, including periodic re-inspection and surveillance activities. 40 C.F.R. §§ 763.84(c), 763.94(g)(4).
Prior to opening, an engineering firm was engaged to test the school site for asbestos. None was found. It is the intention of Brookhaven Innovation Academy to comply with all federal and state regulations controlling asbestos and to take whatever steps are necessary to ensure students and employees a healthy and safe environment in which to learn and work. You are welcome to review a copy of the asbestos management plan in the school administrative office during regular business hours.
Rights Under the Protection of Pupil Rights Amendment (PPRA) PPRA affords parents certain rights regarding conduct of surveys, collection and use of information for marketing purposes, and certain physical exams. These include the right to:
Consent before students are required to submit to a survey that concerns one or more of the following protected areas (“protected information survey”) if the survey is funded in whole or in part by a program of the U.S. Department of Education (ED)-
- Political affiliations or beliefs of the student or student’s parent;
- Mental or psychological problems of the student or student’s family;
- Sex behavior or attitudes;
- Illegal, anti-social, self-incriminating, or demeaning behavior;
- Critical appraisals of others with whom respondents have close family relationships;
- Legally recognized privileged relationships, such as with lawyers, doctors, or ministers;
- Religious practices, affiliations, or beliefs of the student or parents; or
- Income, other than as required by law to determine program eligibility.
Receive notice and an opportunity to opt a student out of –
Any other protected information survey, regardless of funding;
- Any non-emergency, invasive physical exam or screening required as a condition of attendance, administered by the school or its agent, and not necessary to protect the immediate health and safety of a student, except for hearing, vision, or scoliosis screenings, or any physical exam or screening permitted or required under State law; and
- Activities involving collection, disclosure, or use of personal information obtained from students for marketing or to sell or otherwise distribute the information to others.
Inspect, upon request and before administration or use –
- Protected information surveys of students;
- Instruments used to collect personal information from students for any of the above marketing, sales, or other distribution purposes; and
- Instructional material used as part of the educational curriculum.
These rights transfer to from the parents to a student who is 18 years old or an emancipated minor under State law.
Brookhaven Innovation Academy has adopted policies regarding these rights, as well as arrangements to protect student privacy in the administration of protected information surveys and the collection, disclosure, or use of personal information for marketing, sales, or other distribution purposes. Brookhaven Innovation Academy will directly notify parents of these policies at least annually at the start of each school year and after any substantive changes. Brookhaven Innovation Academy will also directly notify, such as through U.S. Mail or email, parents of students who are scheduled to participate in the specific activities or surveys noted below and will provide an opportunity for the parent to opt his or her child out of participation of the specific activity or survey. Brookhaven Innovation Academy will make this notification to parents at the beginning of the school year if the school has identified the specific or approximate dates of the activities or surveys at that time. For surveys and activities scheduled after the school year starts, parents will be provided reasonable notification of the planned activities and surveys listed below and be provided an opportunity to opt their child out of such activities and surveys. Parents will also be provided an opportunity to review any pertinent surveys. Following is a list of the specific activities and surveys covered under this requirement:
- Collection, disclosure, or use of personal information for marketing, sales or other distribution.
- Administration of any protected information survey not funded in whole or in part by ED.
- Any non-emergency, invasive physical examination or screening as described above.
Parents who believe their rights have been violated may file a complaint with:
Family Policy Compliance Office
U.S. Department of Education
400 Maryland Avenue, S.W.
Washington, D.C. 20202-8520
NOTICE OF HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
The School is required by the privacy regulations issued under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) to maintain the privacy of Protected Health Information and to provide our students, parents, and employees with notice of our legal duties and privacy practices concerning Protected Health Information. In the event applicable law, other than HIPAA, prohibits or materially limits our uses and disclosures of Protected Health Information, as set forth below, we will restrict our uses or disclosure of your Protected Health Information in accordance with the more stringent standard. We are required to abide by the terms of this Notice so long as it remains in effect. We reserve the right to change the terms of this Notice of Privacy Practices as necessary and to make the new Notice effective for all Protected Health Information maintained by the School. In the event the School changes any of its policies with respect to privacy or this Notice of Privacy Practices, such change shall be reflected in subsequent annual School publications.
Protected Health Information (“PHI”) means individually identifiable health information, as defined by HIPAA, that is created or received by the School and that relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual; and that identifies the individual or for which there is a reasonable basis to believe the information can be used to identify the individual. PHI includes information of persons living or deceased.
USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION: The following categories describe different ways that we use and disclose PHI.
Your Authorization – Except as outlined below, we will not use or disclose your PHI unless you have signed a form authorizing the use or disclosure. You have the right to revoke that authorization in writing except to the extent that we have taken action in reliance upon the authorization or that the authorization was obtained as a condition of obtaining insurance, and we have the right, under other law, to contest a claim under the policy or the policy itself.
Uses and Disclosures for Payment – We may make requests, uses, and disclosures of your PHI as necessary for payment purposes. For example, we may give information to your doctor’s office to confirm your benefits.
Uses and Disclosures for Health Care Operations – We may use and disclose your PHI as necessary for our health care operations. For example, we may use your PHI in order to coordinate services provided to you.
Uses and Disclosures for Treatment – If you are available and do not object, we may disclose your PHI to your family, friends, and others who are involved in your care or payment of a claim. If you are unavailable or incapacitated and we determine that a limited disclosure is in your best interest, we may share limited PHI with such individuals.
Business Associates – Certain aspects and components of our services are performed through contracts with outside persons or organizations. Claims administration would be an example of such a service. At times it may be necessary for us to provide certain of your PHI to one or more of these outside persons or organizations.
Other Uses and Disclosures – We may make certain other uses and disclosures of your PHI without your authorization.
We may use or disclose your PHI for any purpose required by law. For example, the School may be required
by law to use or disclose your PHI to respond to a court order.
We may disclose your PHI for public health activities, such as reporting of disease, injury, birth and death, and for public health investigations.
- We may disclose your PHI to the proper authorities if we suspect child abuse or neglect; we may also disclose your PHI if we believe you to be a victim of abuse, neglect, or domestic violence.
- We may disclose your PHI if authorized by law to a government oversight agency (e.g., a state insurance department) conducting audits, investigations, or civil or criminal proceedings.
- We may disclose your PHI in the course of a judicial or administrative proceeding (e.g., to respond to a subpoena or discovery request).
- We may disclose your PHI to the proper authorities for law enforcement purposes.
- We may disclose your PHI to coroners, medical examiners, and/or funeral directors consistent with law.
- We may use or disclose your PHI for cadaver organ, eye or tissue donation.
- We may use or disclose your PHI for research purposes, but only as permitted by law.
- We may use or disclose PHI to avert a serious threat to health or safety.
- We may use or disclose your PHI if you are a member of the military as required by armed forces services, and we may also disclose your PHI for other specialized government functions such as national security or intelligence activities.
- We may disclose your PHI to workers’ compensation agencies for your workers’ compensation benefit determination.
- We will, if required by law, release your PHI to the Secretary of the Department of Health and Human Services for enforcement of HIPAA.
RIGHTS THAT YOU HAVE
Access to Your PHI – You have the right to copy and/or inspect certain of your PHI that we maintain. Certain requests for access to your PHI must be in writing, must state that you want access to your PHI and must be signed by you or your representative (e.g., requests for medical records provided to us directly from your health care provider).
Amendments to Your PHI – You have the right to request that the PHI that we maintain about you be amended or corrected. We are not obligated to make all requested amendments but will give each request careful consideration. To be considered, your amendment request must be in writing, must be signed by you or your representative, and must state the reasons for the amendment/correction request.
Accounting for Disclosures of Your PHI – You have the right to receive an accounting of certain disclosures made by us of your PHI. To be considered, your accounting requests must be in writing and signed by you or your representative. The first accounting in any 12-month period is free; however, we may charge you a fee for each subsequent accounting you request within the same 12-month period.
Restrictions on Use and Disclosure of Your PHI – You have the right to request restrictions on certain of our uses and disclosures of your PHI for treatment, payment or health care operations, disclosures made to persons involved in your care, and disclosures for disaster relief purposes. Your request must describe in detail the restriction you are requesting. HIPAA does not require us to agree to your request but we will accommodate reasonable requests when appropriate. In addition,
We retain the right to terminate an agreed-to restriction if we believe such termination is appropriate. In the event of a termination by us, we will notify you of such termination. You also have the right to terminate, in writing or orally, any agreed-to restriction.
Request for Confidential Communications – You have the right to request that communications regarding your PHI be made by alternative means or at alternative locations. We are required to accommodate reasonable requests if you inform
If we maintain PHI in an electronic format, you may request that we provide that information to you or to a third party in electronic format at your request, we are required to restrict disclosures of PHI to a health plan for purposes of carrying out payment or health care operations when the PHI pertains to items or services for which the provider has been paid in full out-of-pocket. us that disclosure of all or part of your information could place you in danger. Requests for confidential communications must be in writing, signed by you or your representative, and sent to the school district at the address below.
Right to a Copy of the Notice – You have the right to a paper copy of the Notice of Privacy Practices upon request by contacting the School at the telephone number or address below.
Complaints – If you believe your privacy rights have been violated, you can file a complaint in writing to Brookhaven Innovation Academy, 3159 Campus Drive, Norcross, GA 30071 or by calling 770-538-1550. You may also file a complaint in writing with the Secretary of the U.S. Department of Health and Human Services in Washington, D.C., within 180 days of a violation of your rights. There will be no retaliation for filing a complaint.