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Georgia Department of Health Form 3300 Certificate of Vision, Hearing, Dental, and Nutrition Screening |
Georgia Department of Health Form 3300
The state of Georgia requires all students attending a public school to have DPH Form 3300 on file. For a Form 3300 to be complete, all screenings must be completed with the screening indication, the physician stamp and signature of physician.
The DPH Form 3300 is acceptable when all the following are completed.
- Students name & date of birth
- Screening check marks on all 4 sections
- Screeners signature on all 4 sections
- Physicians contact information on all 4 sections unless all 4 sections were completed at the same pediatrician office.
If a disability or other health condition precludes a child from taking or passing any of the four screening components, then the physician screening for that component shall explain on the Certificate why the test could not be administered or passed, note whether the child is under professional care, and provide any further information that might assist school authorities with the child's educational planning.
GCA will accept multiple forms with different screenings and information if all forms will satisfy all 4 sections of the 3300 Form Requirement.