The 33 Georgia forms that ask for a clinician's input, from school certificates and GHSA physicals to workers' comp reports, pension disability and Form 1013.
This page lists the 33 Georgia forms that ask for a clinician's input, grouped by program. School-age patients need the Georgia Certificate of Immunization, Form 3231, printed from GRITS, the Form 3300 vision, hearing, dental and nutrition screening, and the GHSA preparticipation physical. On workers' comp claims the authorized treating physician files the WC-20a Medical Report. The MV-9D covers disability placards and plates, and Form 1013 starts an involuntary mental health evaluation.
Section D of the MV-9D must be signed before a notary, though permanent placard renewals need no notarization. File three copies of the WC-20a with the insurer; the Board returns outdated versions of its forms. Form 1013 requires an exam within the preceding 48 hours. TRS wants 12 months of records with the DB-3 and ERS 18 months with its Part IV report, and physicians are asked to bill the member for any charges. 2 forms here have a Spanish version, including the GHSA physical.
WC-20aInitial, interim or final physician report of history, findings, diagnosis, treatment, prognosis, return-to-work status/restrictions, maximum recovery date and any permanent disability rating (AMA Guides).
Lets an authorized medical provider request advance authorization of treatment or testing; the insurer must respond within 5 business days or the request stands pre-approved.
WC-240aDescribes the physical demands of an offered job so the authorized treating physician can approve or disapprove it as suitable employment before a WC-240 offer.
Treating physician states whether a TRS Georgia member applying for disability retirement can perform the attached job description, which duties they cannot perform, and the disability diagnosis.
Treating physician evaluates whether the ERS member is medically or physically incapable of performing the attached job description and whether the incapacity is likely permanent, for the ERSGA Medical Board.
Mental health treating source's report on diagnosis, functioning and ability to perform the job for a TRS Georgia disability retirement application.
Requests that each hospital or clinic that treated the member in the past 12 months send history, operative, radiology, lab and discharge records to TRS for a disability retirement decision.
Treating physician evaluates whether a Georgia PSERS member (school bus drivers, food service and other non-certified school staff) is incapable of performing the attached job description and whether the incapacity is likely permanent.
DDS-MR 287Physician's evaluation of the medical concerns listed in a DDS medical review letter, used to clear, restrict or revoke the driver's license.
DDS-MR-274Eye doctor's report of visual acuity and recommended restrictions (no expressways, daylight only, bioptic) when vision is in question during a medical review or licensing.
Asks DDS to perform a medical review of a person's capacity to drive safely; can be filed by a doctor, relative, court or law enforcement.
Eye doctor's certification of visual acuity so a commercial license holder can renew online.
DDS-MR-MAHealthcare provider specifies the adaptive equipment or restrictions (hand controls, left accelerator, mirrors, automatic transmission, etc.) a driver needs to drive safely.
Applies for a temporary, permanent or special permanent disability parking placard or disabled person's license plate, with a notarized health care provider certification.
Certifies a mental or physical disability so the applicant can get a reduced-fare Breeze Card.
Professional certification of the applicant's ability or inability to use MARTA bus and rail, used to decide ADA paratransit (MARTA Mobility) eligibility categories 1-3.
Physician's recommendation and medical information used to establish nursing facility or ICF/ID level of care for Georgia Medicaid.
Physician certification of medical necessity (qualifying test results, flow rate) for Medicaid home oxygen equipment.
Physician certification of medical necessity, with PT/OT evaluation, for a Medicaid power wheelchair.
DMA 610Georgia Medicaid fee-for-service prior authorization request for DME, orthotics/prosthetics and case management services.
Physician's recommendation documenting a child's need for institutional level of care, used for TEFRA/Katie Beckett and pediatric level-of-care determinations.
Certifies the vision, hearing, dental and nutrition screening required for children entering a Georgia public school (any grade) or within 12 months of entry.
Annual medical history, physical exam and clearance required for participation in GHSA athletics.
Form 3231Required certificate for every child in Georgia child care, pre-K, Head Start and K-12 showing required immunizations, including a medical exemption designation.
Georgia WIC RMFMedical documentation required by 7 CFR 246.10(d) for WIC to issue exempt infant formula, WIC-eligible nutritionals or non-contract formula, and to modify WIC foods, for a participant with a qualifying medical condition.
Initiates involuntary transport and mental health evaluation of a person who presents a substantial risk of imminent harm to self or others because of mental illness.
Substance use disorder counterpart of Form 1013: initiates involuntary transport and evaluation of a person with alcohol or drug dependence who presents a substantial risk of imminent harm.
Annual physician certification that a Georgia resident has a qualifying condition and is eligible for low-THC oil (medical cannabis), designating up to two caregivers.
Online referral of suspected child abuse or neglect to Georgia DFCS Child Protective Services by a mandated reporter.
Online case reporting of notifiable diseases and conditions (and HIV adult/pediatric case reports via eACRF/ePCRF) to Georgia DPH.
Paper case report of a notifiable disease or condition (with viral hepatitis lab section) to the district health office.
Online report of suspected abuse, neglect or exploitation of a disabled adult or elder person to Georgia Adult Protective Services.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
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Yes, for most applications. The health care provider signs Section D, the medical certification, in front of a notary. Renewals of permanent placards need no notarization. The form covers temporary, permanent and special permanent placards and the disabled person's license plate; the gold special permanent placard is for drivers who use hand controls or have lost both upper extremities. The applicant submits it at the county tag office.
Print it from GRITS, the Georgia Registry of Immunization Transactions and Services. A physician's office or public health department generates the certificate; no blank form is posted. Every child in Georgia child care, pre-K, Head Start and K-12 needs Form 3231 on file. A medical exemption is recorded on the certificate itself, with the physician's signature and a review date. The parent gives it to the school or child care.
A physician, psychologist, licensed clinical social worker, licensed professional counselor or psychiatric clinical nurse specialist who examined the person within the preceding 48 hours. The certificate authorizes transport of a person who presents a substantial risk of imminent harm because of mental illness to an emergency receiving facility, and it is valid for 7 days. Form 2013 is the counterpart for alcohol or drug dependence.
Three, with the insurer or self-insurer. The authorized treating physician marks the report as initial, interim or final and covers history, findings, diagnosis, treatment, prognosis, return-to-work status and restrictions, maximum recovery date and any permanent disability rating under the AMA Guides. Not filing it can jeopardize payment of your fees. To ask for advance approval of treatment or testing, use the WC-205; the insurer has 5 business days to respond.