- Georgia Immunization Form 3231 Download
- Immunization Form 3231
- Georgia Immunization Form 3231 Download 2016
Form 3231 (Rev. 02/2010) Use required on or after July 1, 2007. Georgia Department of Community Health CERTIFICATE OF IMMUNIZATION Form 3231 (Fill in X) Child's Name (Last name first) Birthdate Date of Expiration Complete For School Attendance (Optional) Parent/Guardian Name (Last name first).
UPDATE – March 1, 2019: Applications are now closed for 2019-20 Pre-K. The drawing is set for March 13. Please contact your child’s school for additional information.
2019-20 Registration Process
Pre-K applications for the 2019-2020 school year will be accepted beginning Friday, February 1, 2019, at all Jackson County elementary schools. Children must be 4 years old by September 1, 2019, and must live in the school’s attendance zone to apply for Pre-K.
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The deadline to submit an application is 2 p.m. February 28, 2019.
There are a limited number of spaces in the Pre-K program, and completion of the application process does not guarantee enrollment. If the number of applications exceeds the spots available, a drawing will be heldMarch 13, 2019 (not March 14 as previously announced).
- Application forms are available at each school (they are not available electronically).
- Only completed applications that have been returned by the deadline will be considered.
- All applicants will be notified of their status by mail after the drawing takes place.
- If you have a question about the school for which your residence is zoned, please call us at 706-367-5151.
Georgia Immunization Form 3231 Download
You will need the following items to complete the application process:
- Proof of residency in the parent/guardian’s name. The following are acceptable:
- Copy of home settlement statement or mortgage statement.
- Copy of current lease agreement signed by the landlord (handwritten notes are not accepted).
- Copy of current utility bill/service connection with parent/guardian’s name and service address.
- Copy of current homeowner’s insurance statement with parent/guardian’s name and address.
Should living arrangements be a multi-residence household or a shared household, and the parent/guardian is not the homeowner or head of household, a Student Residency Questionnaire and a Certificate of Multi-Family Residence form must be completed, notarized, and on file. The school can provide notary if needed.
- Student’s Birth Certificate, hospital-issued birth record, or religious birth record.*
Proof of Guardianship/Custody Agreement is required when both birth parents are listed on the birth certificate but do not live in the same household.
- Child’s Social Security Card or signed waiver
SSN waiver available atthe time of registration
- Parent/guardian proof of identification
Examples are: Photo ID, passport, work badge, etc.
Available through/conducted by the local health department or a Georgia physician. Required for children entering Georgia schools for the first time.
- Georgia Immunization Form 3231. Available only through the Health Department or a Georgia physician.
If your child was born in Georgia, the Vital Records Department of Jackson County, which is part of the Probate Court, can provide a certified copy of the birth certificate for a small fee. With proper ID and $25, you can get a certified copy of the birth certificate on the spot — even if there are issues you can usually get one within ~72 hours.
Click here to read more, BUT don’t be put off by the “download and mail this form” statement — you CAN go in person and get the BC on the spot or apply in person for the 72-hour version. If cost is an issue, contact Rachel Duke, our lead social worker, at 706-367-5151.
If your child was NOT born in Georgia, check with the Vital Records office in the state of birth; many states offer similar services online.
The Jackson County School System does not and will not discriminate
based on race, color, national origin, or immigration status.
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More Information
- Registration Information
Registration forms
- Georgia Department of Public Health Form 3300 (required only for children entering Georgia schools for the first time)
NOTE: Georgia Immunization Form 3231 is available only through the Health Department or a Georgia physician.
McKinney-Vento Education for Homeless Children and Youth
The McKinney-Vento Education for Homeless Children and Youth program is designed to address the problems that homeless children and youth have faced in enrolling, attending, and succeeding in school. Under this program, state educational agencies must ensure that each homeless child and youth has equal access to the same free, appropriate public education, including a public preschool education, as other children and youth.
If the McKinney-Vento Act applies to your family, the school registrar/school social worker will be able to assist with the registration process.If you have further questions regarding registration, please contact the school the student will be attending.
Electronic Request via Patient Portal
Many requests for records can be made through our patient portal. These include requests for referrals, immunization records requests and hearing and vision records requests. Simply sign into the patient portal and send us an email request for any of these items.
Referral Request – To complete this form you will need the following information about the specialist you are being referred to: specialist’s name (or if scheduled with a physician’s assistant or nurse practitioner, their supervising physician), date of the appointment, address and phone / fax number of practice.
Immunization Records Request (3231) – If this will be released to an outside organization, you’ll also need to complete the Medical Records Release FROM KP 2018. This form requires 48-72 hours for completion. This is a state form that certifies a child is up to date on immunizations, therefore your child must be fully up to date on all required immunizations for us to issue this form. If you child is not up to date, we can issue an Immunization List of all vaccines your child has received. You can also download this list from the portal at any time.
NOTE: If you child will be attending college, you may want to request the University System of Georgia immunization form. This form certifies the student is up to date on vaccines required by colleges and universities and is used by schools both in Georgia and in other states.
Hearing and Vision Records Request (3300)– If this will be released to an outside organization, you’ll also need to complete the Medical Records Release FROM KP 2018. This form requires 48-72 hours for completion. For us to complete this form, your child MUST be up to date on their well-child visit AND have a valid hearing and vision exam within the last 12 months.
Katie Beckett Forms
These require 7-14 business days for completion. Your child must be up to date with their well child exams and have any/all supporting documentation from specialists, labs, therapist, and counselors on file with Kennesaw Pediatrics. These comprehensive forms require a great deal of time and review. You are responsible for ensuring all appropriate documentation is present at the time of your request.
Family Medical Leave Act (FMLA) Form
This form requires 7-14 business days for completion.
Immunization Form 3231
FORM FEES
Georgia Immunization Form 3231 Download 2016
Immunization Records (3231) are provided at each well check, free of charge. Hearing and Vision Forms (3300) are also provided free of charge at any visit in which hearing and vision are checked. University System of Georgia Immunization forms are provided free of charge upon request at a well check. Sports or camp forms brought to the exam are also completed free of charge. Replacement 3231 or 3300 forms, or other forms that are dropped off for completion at a time other than an exam, are $10 per form. Because of the substantial time involved in completion, initial Katie Beckett applications are $75.