Student Health Information
Please note that all student health information must be updated every year.
Please fill out the following form (and additional forms that are necessary for your child) by July 13, 2012 and return to Susan Fullerton, school nurse.
via fax: 404-233-0665
Susan's phone number (for additional questions): 404-231-6714
Medical Information Form - Needed for every student in all four schools.
This is two versions of the same form - you only need to return one copy
Version 2:
Medical Information Form - this version is a PDF that you can fill out on your computer. You must then
save it to your computer and email it as an attachment to the nurse (please note: this file takes a few minutes to download & open). You could also print the filled out form and bring it in or mail it.
Form Needed for Students taking ANY medication
Medication Consent Form - needed for all medications, including those taken at home and those to be administered at school
Specific Medical Issues Forms - needed for students who have any of these health issues
Certificate of Immunization Requirements
A CERTIFICATE OF IMMUNIZATION (Form 3231) is required by Georgia Law 20-2-771 for every student. Georgia law mandates that each child enrolled in a school program must be appropriately immunized with all of the required vaccines at the time of entry into school. The Form 3231, signed by a licensed health-care provider or the county health department, must be provided by the parent at the time of enrollment and must be marked “Complete for School” OR have a future expiration date. Expired certificates will not be accepted for enrollment. The Form 3231 must be provided for each student unless one of the following situations exists:
- Religious beliefs exemption: For a child to be exempt from immunizations on religious grounds, the parent must provide the school with a notarized statement that must include the following: (A) a statement that the family's religious beliefs conflict with the immunization requirements; (B) the statement must be signed and dated by the parent: (C) the statement must be notarized, signed, and dated by a Notary Public; (D) the statement is submitted to the school in lieu of the immunization certifcate (Form 3231); (E) the statement does not expire.
- Medical Waivers/Exemptions: If a child has not received immunizations because of a medical condition, the medical provider indicates those waivers/exemptions on the Georgia Form 3231. These waivers must be reviewed annually.
Recommended immunization schedule can be found here.
Useful information about immunizations:
Certificate of Eye, Ear, and Dental Examinations (Form 3300)
All students in Hamm Full Day Classes, Kenan Pre-K Classes, and Stepping Stones Boulders and Pebbles Classes must provide a current certificate of eye, ear and dental examinations on the Georgia Department of Human Resources Form 3300. The Form 3300 certificate must be provided within 30 calendar days of school entry, and must completed by the physician or local health department. The exam must be dated within the previous year. Forms may be obtained and completed at the local public health department or at your child's physician's office. A copy of the Form 3300 is also attached below.