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Tamara Dent,MSN,RN
School Nurse
Phone: 706.868.4022 Ext 1633
Email: dentta@boe.richmond.k12.ga.us
Fax: 706-868-3647
"You can't educate a child who is not healthy and you can't keep a child healthy who is not educated"
-Jocelyn Elders
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Georgia 3300 Form
To verify that every child in Georgia has been 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.
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Sample 3231 GA Immunization Form
Georgia 3231 Immunization Form required for all students. Out of state immunization forms will need to be transferred to a 3231 form by a GA medical provider or GA department of health. Thanks
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Religious Exemption Form
Form must be signed and notarized for religious exemption from immunizations. Thanks
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Spanish Religious Exemption Form
Form must be signed and notarized for religious exemption from immunizations. Thanks
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Prescription Medication Form
Medication Administration Form to be completed and signed by health care provider and parent for prescription medication such as pills, medicated creams or ointments, etc. Medication must be in the original container with a pharmacy label that matches the medication form. Medication must be brought in by an adult.
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Over the counter Medication Form
OTC Medication Administration Form to be completed and signed by a parent for over the counter medication such as Ibuprofen or Tylenol.The dose must be age appropriate and must match instructions on the container. Medication must be in the original container with the students' name on it. Medication must be brought in by an adult. Thanks
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Asthma &/or Allergy Care Plan
For students with asthma and/ or allergies. Form to be completed and signed by health care provider and parent for Epi Pen & Inhaler. Medication must be in the original container with a pharmacy label that matches the medication form. Medication must be brought in by an adult. Thanks
