• Augusta School-Based Health Services

    2025-2026
  • Hello Augusta Panthers:

    PrimaryPlus-Bracken County has been a trusted and invested healthcare partner in the community and is excited to bring school health services to the students and faculty of Augusta Independent Schools. Our school services will provide an extension off our PrimaryPlus-Bracken County facilities. We are also happy to continue to grow our dental services through our School-Based Dental Center that is located at 106 Powell St. in Brooksville. Our school services include:

    Medical Services: Our team for the school health program will be the familiar faces of the PrimaryPlus-Bracken facility that is located at 1551 Augusta-Chatham Rd. The telemedicine program with Augusta Schools is here to be an added resource to parents and IS NOT designed to replace your child’s pediatrician or routine medical provider. In fact, we wish to be a partner in your child’s care and ANY visits that he/she may have with our program--we will be happy to share the visit notes with his/her regular medical provider. As a school-based health center PrimaryPlus’ goal is to provide a convenient, yet quality healthcare evaluation upon parental consent when your child has any minor sickness such as earache, throat infection, eye infection, skin irritation, cold, runny nose, etc. Our services will be like a “minute clinic” setting within the school nurse office—these appointments are via telemedicine (parents are welcome to join in the virtual visit). For any questions you can call PrimaryPlus-Bracken County at 606-756-2117.

    Dental Services: Our dental program is a collaboration between PrimaryPlus-Dental Center and the University of Kentucky College of Dentistry featuring the care of dentist, Anna Joines, DMD and hygienist Jacqueline Stitt, RDH.

    Our dental program will visit Augusta Independent Schools a couple times a year for cleanings and screenings. Note: The PrimaryPlus-Dental Center is open four days a week at 106 Powell St. in Brooksville and welcomes you to schedule an appointment by calling 606-402-2075. PrimaryPlus-Dental Center will provide upcoming dates for their school-based dental visits soon.

    Consent Information: Attached are the consent forms for 2025-2026 school-based services. Parents/guardians may select which services they would like their child to participate. Note: If the student is already a patient of PrimaryPlus, you will STILL need to complete the forms because school-based services require added information and must be completed once a year—last year’s consent forms are no longer valid.

    You can find a list of frequently asked questions regarding school-based health and the PrimaryPlus Notice of Privacy and HIPAA Practices at www.primaryplus.net.

    Many Well Wishes for a Great School Year,

    The PrimaryPlus Team

    Consent packets  completed and returned by Wednesday, September 10th, will have an opportunity to WIN 1 of 2 $100 gift cards provided by PrimaryPlus.

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    Service Consent

    Please read carefully, COMPLETE FORM, SIGN, and DATE.  Please notify PrimaryPlus if there are any changes in health information or guardianship. PrimaryPlus collects new consents each school year. If your child is already a patient of PrimaryPlus and you wish to participate in school-based health services, forms must be completed.

    Consent packets are for school-based Primary Care & Dental services ONLY. Counseling Services are referral based OR a parent/guardian can call to schedule for this service.

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  • Please sign below.

    Note that if the parents of the above stated child have joint custody, signatures of both parents are required for consent to treat, please be sure to sign below.

    Patient/Student Signature is ONLY allowed if 18 or OLDER. If under 18, MUST be signed by parent/guardian.

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  • PrimaryPlus shall provide a copy of its Notice of Privacy and HIPAA Practices upon my request, which is also available at www.primaryplus.net.

  • PrimaryPlus School-Based Health Registration Form

  • Patient Information

    Please Complete the following information about your child.

  • Parent/Guardian Information:

    Parent/Guardian #1

  • Parent/Guardian #2 (if applicable)

  • Emergency Contact (Other than Guardian)

  • *PrimaryPlus is happy to share records of your child's visit with their pediatrician or regular primary care provider.

  • Insurance Information

    Please provide insurance information if unable to take photo of insurance card.
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  • Medical History

  • Dental History

  • Other Information

  • I have reviewed the health history form provided by PrimaryPlus and have disclosed all my child's known health history to date. PrimaryPlus asks that you alert us if anything regarding your child's health should change throughout the year.

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  • Consent to Treat

    Physicians of: Lewis County Primary Care Center, Inc./ DBA PrimaryPlus
  • I, _________ (parent/guardian) acting on behalf of ________ (student/patient) who is suffering from a condition requiring medical, podiatric and/or dental care.

    I agree to allow this care to be received. It may include routine diagnostic and medical treatment that the attending physician(s) or others of the health center medical staff consider necessary. Services could include treatment for illness or injury including over the counter medications or necessary prescriptions, well child exams, appropriate immunizations, and appropriate behavioral evaluations--unless emergency services are needed.

    2. I understand that the practice of medicine and surgery is not an exact science, and that diagnosis and treatment may involve risks of injury or even death. I acknowledge that no guarantees have been made to me about the result of examination or treatment in this

    3. I understand that:

    a) Normally, except under emergency or extraordinary circumstances, no important procedures are performed upon a patient unless and until he or she has had an opportunity to discuss them with the physician or other health professionals to the patient's satisfaction.

    b) Each patient has the right to agree or refuse to agree to any proposed procedure or therapeutic course; and

    c) No patient will be involved in any research or experimental procedure without his or her full knowledge and agreement.

    4. I realize that there are medical, nursing and other health care personnel at this health center who are still in training. I understand that they may be present during my care unless I request them not to be present.

    5. This form has been fully explained to me, and I am satisfied, and I understand its content and significance.

    6. Once the student's completed consent and history are received, PrimaryPlus can begin caring for your child for approved services during school hours. Attempts will be made to notify the parent/guardian of your child's appointment and to see if they wish to attend the visit. If no contact is made and all consents are in place, PrimaryPlus will continue the appointment as needed and contact the parent with follow-up information following the appointment including sending home a copy of the care summary.

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  • Note: Patient/Student Signature is ONLY allowed if 18 or OLDER

    I HEREBY CONSENT FOR THE FOLLOWING PERSON/PERSONS TO BRING MY UNDERAGED CHILD TO LEWIS COUNTY PRIMARY CARE CENTER, INC. dba PRIMARYPLUS FOR TREATMENT.

    (Please list name and relationship to child)

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