Form 3300 - Certificate Of Vision, Hearing, Dental, And Nutrition Screening (Page 2 of 2) in pdf

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.

Four different screenings are required: vision, hearing, dental, and nutrition. All four

What screenings are required?

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:

“Needs further evaluation”

What should a parent do if the “needs further evaluation” box is checked?

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.

It is only necessary to file the Form 3300 once.

What if a Form 3300 was previously filed for the child at another school?

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.

Form 3300 - Certificate Of Vision, Hearing, Dental, And Nutrition Screening Page 2