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Tennessee Rehabilitation Center (TRC) at Smyrna and Community Tennessee Rehabilitation Centers (TRC) Student Health Information and Medical Records.

RDA Number
Effective Date
Record Series Abstract
This record series consist of a HIPAA Authorization Form, TRC Student Health Questionnaire, TRC Student Health Medication Sheet, TRC Admissions Medication Sheet, Student Health Medication and Treatment Consent Form, TRC Student Health Referrals, TRC Initial Safety Contact & Plan, Intake Checklist, Student Health Medical Dormitory Inventory of Student's Personal Effects, Med Dorm Student Info Sheet, Student Health Medical File Charts, Student Intake-History and Physical, Physical Exam, TRC Physical Function Assessment, Student Health Doctor's Orders/Progress Notes and Nurse's Notes, Medical Consultant Sheet, TRC Student Health TB Skin Test Record, Self Harm or Threatening Behavior Student Check List, and other related information. The facilities provide Vocational Evaluations, Vocational training, Physical Rehabilitation Services, Traumatic Brain Injury (TBI) Program, Vision Impairment Services (VIS), Work adjustment training, a School to Work Program, Job Placement/Coaching Services, Transitional Living Skills and at our residential facility, TRC Smyrna, an onsite student health dorm.
Record Series Active
Cut Off at End of
If Other, Explain
Cut off happens when student participation in a TRC program or service has ended.
Total Retention Years
Total Retention Months
Retention End Action
Disposition Notes
Upon student admission into a Tennessee Rehabilitation Center (TRC) program a complete medical health history is gathered, in order to best serve and evaluate the students physical limitations and any health risks or hazards. The maintenance and monitoring of TRC student health and medical issues is crucial in providing an optimal learning, living and training environment. The accumulated health history and medical information is a critical tool for staff in developing an individualized learning and training plan, focused on ability rather than disability. The mission of Tennessee Rehabilitation Centers is To provide all program participants individualized, quality, timely services that will lead to gainful employment and an improved quality of life.
Record Location
Tennessee Rehabilitation Center (TRC) at Smyrna & 17 Community Tennessee Rehabilitation Centers (TRC) located across the state.
File Arrangement
Media Format Generated
Media Format Stored
Date Range
Allotment Code
Annual Accumulation
4 cubic feet
Current Volume
128 cubic feet
Record Value
Audit Requirements
Information Shared Outside the State
Shared Agencies
Commission on Accreditation of Rehabilitation Facilities (CARF), U.S. Department of Education
Essential Record
Essential Record Media Type
Confidential Legal Citation
45 CFR 164.530 / 34 CFR 361.38 / TCA 46-11-604 / TCA 49-11-613
Does this Record Series Contain Sensitive Information?
Agency Retention
6 years 0 months
Records Management Division (RMD)
No recommended changes
Tennessee State Library and Archives
No recommended changes.
Comptroller Audit Review
We have reviewed RDA 11178 from an audit standpoint. We concur with the recommended retention and disposition specifications.
Agency Records Officer
No recommended changes
RMD Director
RDA 11178 is a request for a new RDA. The retention period will be six years and destroy. The format will be paper. Recommend approval of request to create RDA 11178.
Public Records Commission
PRC approves RDA 11178.