The Georgia Department of Public Health Form 3300 is essential for the enrollment of a child in a Georgia public school for the first time, requiring certificates of vision, hearing, dental, and nutrition screening. This form must be completed and filed with the child's school, showcasing that the child has been screened for potential issues in these critical areas of health. To ensure your child is ready for school and any health concerns are addressed early, click the button below to fill out the Form 3300.
The Georgia Department of Public Health Form 3300 is a crucial document for any parent or guardian who is enrolling their child in a Georgia public school for the first time. This form serves as a certificate of vision, hearing, dental, and nutrition screening, which are all essential areas of health that can significantly impact a child's ability to learn and thrive in a school environment. These screenings are designed to identify any potential problems early on, allowing parents to seek out the necessary professional assistance as soon as possible. A range of qualified professionals, including doctors, nurses, and specialists within each screening area, are authorized to conduct these screenings. Moreover, the form includes sections for each type of screening and requires detailed information about the screening results, including whether further evaluation is recommended. The importance of this form goes beyond mere formalities; it underscores a commitment to the well-being and academic success of Georgia's children by ensuring they are physically prepared to face the challenges of schooling. Understanding and completing the Form 3300 is a significant step towards this goal, highlighting the broader efforts to support children's health statewide.
Georgia Department of Public Health
Form 3300
Certiicate of Vision, Hearing, Dental, and Nutrition Screening
PLEASE SEE THE INSTRUCTIONS
ON THE BACK OF THIS FORM
FILE THIS FORM WITH THE SCHOOL WHEN YOUR CHILD IS FIRST ENROLLED IN A GEORGIA PUBLIC SCHOOL
SCREENER CONTACT INFORMATION IS REQUIRED
Parent/ Guardian Name:_______________________________________
irst
middle
last
Parent/ Guardian Contact Information:
Daytime phone number:_____________________________________________________________
Evening phone number:_____________________________________________________________
Cell phone number:_________________________________________________________________
Child’s Name:__________________________________________________
Date of Birth: _____/_____/_____
Gender: Male Female
Child’s Home Address:
____________________________________________________________________________________
street
city
state
zip code
county
VISION
Unable to screen (explain why below)
Uses corrective lenses
Worn for testing
Passed (20/30 in each eye for age 6 and above, 20/40 in each eye for below age 6)
Needs further evaluation
Under professional care (explain below)
Screening completed by:
Physician
Local Health Department
Optometrist
“Prevent Blindness Georgia” employee
School Registered Nurse
___________________________________
Screener’s Signature Date
I certify that this child has received the above screening.
Contact Information:
HEARING
Uses hearing aid / assistive device
Passed at 500, 1000, 2000, and 4000 Hz with audiometer at 20 or 25 dB
Audiologist
Speech-Language Pathologist
DENTAL
Normal appearance
Emergency problem observed
Dentist
Local Health Department Registered Nurse
Registered Dental Hygienist
NUTRITION
Height: ___________
Weight: ___________
BMI: _____________
BMI%: ___________
5th to 84th percentile - Appropriate for age
< 5th percentile - Needs further evaluation
≥ 85th percentile - Needs further evaluation
Registered Dietician
FOR SCHOOL SYSTEM ONLY
Follow up for further evaluation
1st attempt
2nd attempt
Actions reported (if any)
Vision
Hearing
Dental
Nutrition
Student support services initiated on:
Screeners’ Comments:
DPH FORM 3300 REV. 2013
Georgia Department of Public Health Form 3300
Certificate of Vision, Hearing, Dental, and Nutrition Screening
Who is required to file this Form 3300? The parent or guardian of a child who is being admitted for the first time to a public school in Georgia must file a completed Form 3300 with the school when the child is enrolled.
What is the purpose of Form 3300? Form 3300 is intended to make sure that every child in Georgia is screened for possible problems with their vision, hearing, teeth and nutrition. The earlier these problems are detected, the earlier parents can seek professional help for the child.
What screenings are required? Four different screenings are required: vision, hearing, dental, and nutrition. All four screenings must be conducted and reported on the form before it can be filed with the school.
Who can conduct the screenings? Your child’s doctor is authorized to conduct all four screenings, as is your local health department. In addition, the vision screening can be conducted by a Georgia licensed optometrist, an employee of Prevent Blindness Georgia trained to conduct vision screening, or a school registered nurse; the hearing screening can be conducted by a Georgia licensed speech-language pathologist or audiologist, or a school registered nurse; the dental screening can be conducted by a Georgia licensed dentist, dental hygienist, or a school registered nurse; and the nutrition screening can be conducted by a Georgia licensed dietician or a school registered nurse. It is not necessary that the same person conduct all four screenings.
What does “BMI” and “BMI%” mean? “BMI” means “body mass index.” BMI is a way to describe how
much a child weighs in relation to height. “BMI percentile” is a way to compare the child’s body mass index to the body mass index of a healthy child. If the child’s BMI is less than 5% or more than 84% of what is appropriate for his or her age
and height, then the child should be taken to a doctor or dietician for a more detailed evaluation. For more information, visit
the Centers for Disease Control and Prevention website on child and teen BMI at: http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html
What should a parent do if the “needs further evaluation” box is checked? “Needs further evaluation”
means that the child may have a problem. If the “needs further evaluation” box is checked, then the parent should
take the child to a professional for a more detailed evaluation. Your doctor or local health department may be able to help, or recommend someone who can help.
What if a Form 3300 was previously filed for the child at another school? It is only necessary to file the Form 3300 once. If the Form 3300 is filed at the child’s first school, and the child later transfers to another school, then the original school is
required to forward the Form 3300 to the new school.
Filling out the Georgia Department of Public Health Form 3300 is a critical step when enrolling your child for the first time in a Georgia public school. This form is essential for ensuring your child has been screened for vision, hearing, dental, and nutrition issues, highlighting the importance of early detection and intervention. The process involves a few straightforward steps that allow healthcare professionals to certify your child's health status in these key areas.
After completing this form with accurate details, it must be submitted to your child's school to comply with Georgia’s public health requirements. This ensures your child receives the necessary support and interventions early, contributing to their overall well-being and academic success. Remember, this form is a critical part of initial school enrollment in Georgia, facilitating prompt follow-ups for any concerns identified during the screening process.
Who is required to file the Form 3300?
Parents or guardians of children who are being admitted for the first time into a public school in Georgia must submit a fully completed Form 3300 at the time of enrollment.
What is the purpose of Form 3300?
The primary purpose of Form 3300 is to ensure that every child in Georgia undergoes screenings for potential problems in their vision, hearing, teeth, and nutrition. Identifying issues early increases the likelihood that intervention can begin promptly.
What screenings are required on Form 3300?
Form 3300 requires four different screenings: vision, hearing, dental, and nutrition. Each of these areas must be screened and the results reported on the form before it can be officially filed with the school.
Who can conduct the screenings required for Form 3300?
The screenings can be conducted by a range of professionals. A child's doctor or the local health department are authorized to perform all four screenings. Additionally, specific screenings may be done by licensed professionals or trained personnel in relevant fields, such as a Georgia licensed optometrist for vision screening, a speech-language pathologist or audiologist for hearing screening, a dentist or dental hygienist for dental screening, and a dietician for nutrition screening. School registered nurses are also able to conduct any of the four screenings.
What do "BMI" and "BMI%" mean on the Form 3300?
"BMI" stands for Body Mass Index, a measurement that calculates a child's weight in relation to their height. The "BMI percentile" compares a child’s BMI to what is typical for other children of the same age and height. If a child's BMI is below the 5th percentile or above the 85th percentile, it suggests that the child should see a doctor or dietician for a more in-depth evaluation.
What should a parent do if the "needs further evaluation" box is checked?
If any section of the form indicates that further evaluation is needed, it means there may be a concern that requires professional attention. Parents should arrange for their child to see a healthcare professional who can provide a detailed assessment. The child’s regular doctor, the local health department, or specialists recommended by these providers are good starting points for obtaining this additional evaluation.
When filling out the Georgia Department of Public Health Form 3300, a common mistake people make is not completing all required sections. This form consists of vision, hearing, dental, and nutrition screenings. Each section requires specific information about the child's health and screening results. Leaving sections incomplete can delay the enrollment process because the form must be entirely filled out before a child can be admitted to a Georgia public school for the first time.
Another mistake often made is misunderstanding what "BMI" and "BMI%" stand for, which leads to incorrect or incomplete entries in the nutrition section. "BMI" means Body Mass Index, a measurement that compares weight to height. "BMI%" refers to the percentile ranking based on the child's BMI, comparing it to others of the same age and gender. Misinterpreting these terms can result in inaccuracies that may overlook a child's need for further nutrition evaluation. Proper understanding and accurate reporting in these fields are crucial.
Often, parents and guardians overlook the importance of screener contact information. Each screening section requires the contact details of the individual or organization that performed the screening. This mistake can cause significant issues if the school needs to follow up on the screening results. Ensuring the screener's contact information is accurate and complete enables efficient communication between the school and the screener if further clarification or action is needed regarding a child's health screening results.
Lastly, a frequent oversight is not paying attention to the instruction that screenings can be conducted by different qualified professionals. Some believe that only a child’s primary healthcare provider can complete this form. However, vision screenings can be done by optometrists, employees of Prevent Blindness Georgia, or school registered nurses, among others. Similarly, audiologists, speech-language pathologists, dentists, dental hygienists, registered dieticians, and school registered nurses are among the professionals authorized to conduct the respective screenings. This misunderstanding can lead to delays in completing the form due to scheduling difficulties or other obstacles. Knowing who is qualified to perform each screening can streamline the process significantly.
When filing the Georgia Department of Public Health Form 3300 for a child's enrollment in a Georgia public school, it's essential to understand that this document does not stand alone. To ensure a comprehensive approach to a child's healthcare and readiness for school, several other forms and documents frequently complement the Form 3300. Knowing these associated documents can help streamline the enrollment process and ensure all health-related requirements are met.
By thoroughly preparing and submitting these documents in conjunction with Form 3300, parents and guardians can aid in providing a full picture of the child’s health and educational needs. This holistic approach ensures that all children have the necessary support and accommodations to thrive in their educational journey. Understanding and organizing these forms as part of the enrollment process emphasizes the importance of a child's health and well-being in their academic success.
The Form 3300 from the Georgia Department of Public Health is analogous to several other health-related screening and documentation forms used across the United States, each tailored to monitor and ensure the well-being of individuals, especially children, within various public and private institutions. One such document is the Universal Child Health Record, often used in states like New Jersey. This form, similar to Form 3300, is required for children entering public schools for the first time and covers a range of health checks including immunizations, medical history, and physical assessments, aimed at identifying any potential health issues that could affect a child’s educational experience.
Another akin document is the School Entry Health Exam Certificate, prevalent in states like Florida, which mandates a comprehensive health examination covering vision, hearing, growth measurements, and a general physical appraisal. This form, akin to the Form 3300, ensures that health barriers to learning are identified and addressed early on, facilitating a better educational experience for entering students.
The California School Immunization Record is a document focused more narrowly than the Form 3300 but shares the goal of safeguarding children’s health within a school environment. This form tracks immunizations against diseases such as measles, mumps, and whooping cough, emphasizing the importance of preventing outbreaks and maintaining a healthy school community. Though it is more specific in its health focus, it complements the comprehensive screenings covered by Form 3300 by ensuring another aspect of child health is monitored.
The Adolescent Well-Check Flyer, often used for older children, parallels the Form 3300's objective of early detection of health issues that could impede a student's academic and social development. By focusing on teenagers, this document addresses age-specific concerns such as mental health, nutrition, and risk behaviors, highlighting the continued need for health monitoring as children grow.
The Early Childhood Screening Record, employed in Minnesota, shares similarities with Georgia’s Form 3300, focusing on early detection of health or developmental problems in preschool-aged children. It covers vision and hearing screenings among other evaluations, ensuring children are ready to learn and succeed upon school entry. This document underscores the importance of early interventions, akin to the philosophy behind Form 3300.
The Preparticipation Physical Evaluation, widely used for school-aged athletes across the country, while not identical, serves a complementary purpose to the Form 3300 by focusing on assessing a child’s physical readiness to participate in sports. This form includes a medical history and a physical examination, with an emphasis on identifying conditions that might put the student at risk during physical activity, illustrating an aspect of child health and safety within the school setting.
The Immunization Certificate, analogous to specific sections of various state-required health forms, including the Form 3300, is pivotal in ensuring that children are vaccinated against common communicable diseases before entering public schools. By requiring proof of immunization, this document, like the Form 3300, plays a crucial role in public health and the prevention of disease outbreaks within educational settings.
Finally, the Head Start Program Health and Nutrition Screening form, part of the federal Head Start program, encompasses a broad range of screenings similar to those in Form 3300, aimed at ensuring that children from low-income families are healthy, well-nourished, and ready to learn. This document reflects a comprehensive approach to assessing child well-being, aligning with Form 3300’s objectives of identifying and addressing early any health-related issues that could impact a child's ability to succeed in school.
In essence, while each of these documents serves specific populations or focuses on particular aspects of health, they collectively underscore the importance of early health screenings and interventions for children. By identifying potential health issues before they become barriers to learning, these forms facilitate better educational outcomes and overall well-being for children.
When you're preparing to fill out the Georgia Department of Public Health Form 3300, it's essential to approach this task with care to ensure that all information is accurately and completely provided. This form is a critical step in ensuring your child receives the necessary screenings for vision, hearing, dental, and nutrition before enrolling in a Georgia public school for the first time. Below is a list of dos and don'ts to guide you through this process:
By following these guidelines, you can ensure the Form 3300 is filled out correctly and thoroughly, laying the groundwork for a smooth enrollment process for your child in the Georgia public school system. Remember, the purpose of this form and its requirements is to support the health and well-being of your child, making it an important step not to be overlooked.
Only Certified Healthcare Professionals Can Complete the Ga 3300 Form: This is not completely accurate. While it is true that healthcare professionals like doctors, optometrists, and dentists can conduct the screenings, the Form 3300 can also be completed by trained employees of Prevent Blindness Georgia, speech-language pathologists, audiologists, registered nurses at schools, and registered dieticians. The aim is to ensure comprehensive screenings without restricting them to a specific type of healthcare provider.
Every Section of the Form Must Be Completed by the Same Screener: This is a misunderstanding. The Form 3300 is designed to record screenings from various professionals. A child’s vision might be screened by an optometrist, hearing by an audiologist, dental health by a dentist, and nutrition status by a registered dietician. The form accommodates input from multiple screeners, reflecting a collaborative approach to the child’s health.
The Form is Only Necessary for Enrollment in Public Schools: While primarily associated with public school enrolment, the importance of the Form 3300 goes beyond this requirement. It serves as a vital checkpoint for children’s health, irrespective of their education setting. While it is filed with public schools as part of the enrolment process, the screenings are beneficial for all children and can support their wellbeing in any setting.
Screening Results on the Ga 3300 Form Immediately Disqualify a Child from School Enrollment: This misconception can cause unnecessary worry. The purpose of Form 3300 is to identify potential health issues early on, not to serve as a barrier to education. If a section of the form indicates that further evaluation is needed, this does not prevent school enrollment. Instead, it prompts guardians to seek further professional evaluation and assistance for the identified issue.
BMI Information on the Form Discriminates Based on Weight: The inclusion of BMI and BMI percentile in the nutrition section is often misunderstood. These metrics are not used to stigmatize or discriminate against children based on their weight. Instead, they provide a standardized method to identify potential nutrition-related health issues. When a child’s BMI falls outside the recommended percentiles, it signals a need for further evaluation to ensure they receive proper care and guidance, supporting their overall health and wellbeing.
Understanding the Georgia Department of Public Health Form 3300 is crucial for parents enrolling their child for the first time in a Georgia public school. Here are ten key takeaways to guide you through filling out and using the form effectively:
Remember, completing and filing Form 3300 is an important step in ensuring your child's health and readiness for school. Should you need further clarification or assistance, your local health department or child's school can provide support.
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