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Form 3300 Certificate of Vision, Hearing, Dental, and Nutrition Screening - Georgia (United States)
What Is Form 3300?
Form 3300, Certificate of Vision, Hearing, Dental, and Nutrition Screening , is a form intended to prove that a child entering a public school has no problems with vision, hearing, teeth, and nutrition.
Alternate Names:
- Georgia Form 3300;
- DPH Form 3300.
The latest version of this form was issued on January 1, 2013 . A 3300 Form fillable version is available for download below{class="scroll_to"}.
This certificate is obtained from your child's physician and is provided by the Georgia Department of Public Health - the lead agency in preventing disease, injury, and disability in Georgia. After it is filled the form has to be provided to a school within 120 days.
If a child is transferred from one public school to another, and they have filled out this form before, they do not have to conduct screenings another time, the previous Form 3300 will be suitable.
The purpose of this form is to make sure that every child in Georgia has their vision, health, teeth, and nutrition checked and that they have no health problems. If a child has problems with any of these sections then it is better to discover it in childhood so that parents can seek professional medical attention for their child (before a child is enrolled at public school). To make a parent understand that their child needs help the screener will check the "Need Further Evaluation" box.
Form 3300 Instructions
Georgia Form 3300 is required to be filled out by a parent or by a guardian of a child who is enrolled at public school.
The first part of the form needs information about the parent/guardian and about the child. You have to provide their personal contact information, including their name, last name, date of birth, home address, and phone number.
The second part of the form requires the subject matter of the certificate. There are 4 sections in the certificate: vision, hearing, dental, and nutrition. These sections are filled by the screener (the screener can be your child's doctor, local health department, or a school registered nurse). All four sections can be filled out by different screeners and - at the end of the screen tests - all the screeners have to sign their sections to confirm that they provided the child with medical screening. After the screeners check the child and fulfill all the sections the form has to be filed with the public school where the child is enrolled.
Download Form 3300 Certificate of Vision, Hearing, Dental, and Nutrition Screening - Georgia (United States)
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