Medical Form Information
Download the Medical
Form Here
The Medical form is the only medical form accepted at
Yankee Clipper Summer camps and can be obtained at the
Council office or at www.yccbsa.org
Most common frustration over the Medical Form comes from
the dates and signatures. Those issues are addressed by the
section below. We also understand some physicians will not
sign the BSA form but will give you an office printout of
medical history. This includes the past medical history,
current medications, with dosages, and times to be taken,
and known drug or environmental allergies. This is fine,
but does not replace the Medical Form. It must be attached
to the Medical Form.
Section One: Very much self explanatory.
If the parents are using camp as a chance for a parental
getaway, they should attach a separate piece of paper with
all contact information for Camp and the Trop.
Section Two: The first two questions are
the point of the section. The following medical conditions
are common. Therefore, in a check box format, explain any
allergies or conditions in this section unless you have an
attached physician's office printout attached to your
medical form.
Section Three: A signature in this section
states that the applicant, parent, or guardian have
reviewed all the information on the form as well as
attached information within the last 12 months. It also
allows for participation and emergency medical treatment.
All signatures must be original and within one year of the
scouts last day in camp. This is also true for any scouter
over the age of 18 who doesn't sign the form. No one
without a signature will be allowed to stay in camp.
Section Four: See back
Section Five: Filled out, signed or
stamped by the physician on the Medical Form or the
attached medical statement. This date corresponds with the
most recent physical date of section six. Both dates cannot
be more than 24 months from the scout or scouters last day
in camp.
Section Six: Filled out by the applicant,
parent or guardian. That date of the most recent physical
cannot be more than 24 months from the scout or scouters
last day in camp.
Section Seven: Filled out or on a medical
statement attached to the Medical Form. This date
corresponds with the most recent physical date of section
five and six. All dates can not be more than 24 months from
the scout or scouters last day in camp.
Back Side******
Part A
* If the Scout or scouter comes to camp with any
medication, this section must be signed for
each current medication. Multiple
meds means multiple forms with signatures or one attached
physician statement from their office. The physician
statement must have all information required. It is the law
in New Hampshire. All medications must be accompanied by
their original medication bottles or packages. No day or
time containers.
* Please put all medication (still in original containers)
in a plastic zip-lock bag with the scout's name and Troop
on it. This is for better organization of the scout's
medication.
* The only medication not to be locked up are Meter dose
inhalers, Epi-pens, and nitroglycerin.
* A parent or guardian must sign this section for all
scouts under the age of 18 as well. Only once per applicant
and must be no more than 12 months from scouts last day in
camp. Without a signature in this section, our nurse or
health officer cannot give your child his medication. We
would also have to call an ambulance for all minor medical
issues. If you don't give permission please tell us why and
what you want us to do incase.
Part B
Immunization requirements are noted and must be on the form
or again, in any attached physician statement.
Points to Remember
* Sunday at camp should not be the first time a Scoutmaster
sees the Medical Form
* Remind parents in January to schedule their scouts
physical. Many pediatricians are booked months in advance
because we are competing with every other camp, sports
league, and illness in the world. An early physical is
never a problem.
* Never send an individual Medical Form to the Council
Office.
* You only need one form for the summer at our camps. Make
a copy if planning on attending outside Yankee Clipper
Council, before arriving to camp.
