Medical Form Instructions
Please read the entire document to ensure all aspects of the forms are complete
General Information
A requirement of Scouting America is to have an active Health and Medical Form on file for each Scout, leader, and any other adult attending outings. Outings are defined as anything that is not a normal scout meeting. If a medical form is not on file, the individual may not attend.
Health forms are provided to healthcare professionals during emergencies if necessary.
Expiration
The Health and Medical Forms remain valid for one year from the date of signature. For general information, please refer to Scouting America: Annual Health and Medical Record. Medical forms from previous years will be securely destroyed.
Paper Versus Digital
According to Scouting America policy, units and leaders are not authorized to routinely obtain or retain digital copies of members' medical forms. Digital copies may only be uploaded when required by a camp or high adventure base, and exclusively for the duration necessary to complete that process.
Paper copies should be submitted directly to leaders during meetings or at drop-off for outings. Medical forms should not be emailed unless specifically requested in relation to a particular event.
It is recommended to maintain a digital version on your own device of your medical forms for ease of updating in future years. Additionally, having extra copies may be beneficial for activities and events such as OA, Firecrafter, or outings outside our unit. Please note that summer camp may not always return submitted medical forms; therefore, those attending camp should ensure they provide two copies of medical forms AB.
Medical Forms
This document contains links to the various medical forms. Please download the correct form and provide us with printed copies and a copy of medical insurance cards if you have insurance.
All members and participants must submit Form A and B along with a copy of their insurance card. If you are attending Summer Camp or High Adventure trips, you also need to provide Form C, which must be signed by a licensed practitioner.
All forms can be found here: Scouting America: Annual Health and Medical Record
Forms A and B
For Scouts or adults who are only going to outings less than 72 hours (i.e., weekend camp outs) you will need forms A and B.
- Provide us with a copy of Forms A and B with a copy of insurance cards.
Form C and Summer Camp / High Adventure Details
For Scouts or adults going to summer camp for any period of time aside from the family night visit and/or high adventure trips; you need form A, B, and C and a copy of the insurance cards. Please keep an extra copy of form C at home.
- Form C requires a physical examination conducted by a licensed practitioner, with their signature provided. It is advisable to scan and retain a copy of this document for your records so that it can be reprinted if necessary.
- Without form C, you or your Scout cannot enter camp and must be picked up immediately.
- Please be advised that, due to local or state regulations, we may not receive medical forms back from summer camp.
- All medications that will be brought to camp must be clearly listed on the required forms.
- It would be the best practice to provide us with the following:
- A copy of Forms A and B with a copy of insurance cards.
- A copy of Forms A, B, and C with a copy of insurance cards for camp.
- This copy will either be retained by the camp due to state law or returned to you after camp.
- Check that EpiPens or asthma inhalers are in date and their device date matches the date listed on form B. Camp medical staff will verify this.
Filling in the Forms
Please ensure that all data are filled out as thoroughly and accurately as possible. In the event that you or your child becomes unconscious or injured, this information will be provided to first responders and hospital personnel.
All signatures must be handwritten in ink; electronic signatures are not recommended.
Form A
Signatures
All signatures, including those from youth participants, must be accompanied by the corresponding dates.
Adults Authorized
Print extra copies of Form A as needed to list additional adults. Include at least one Adult Leader who will transport your scout (e.g., Mr. Koczan for Troop 303, Mr. Leppart for Troop 331, Ms. Barnard for Crew 303). The other adult should be someone you trust.
Form B
Fill out all sections completely
Leader Phone Numbers
- Crew 303
- Lisa Barnard: 317-332-5303
- Troop 303
- Christopher Koczan: 317-250-4601
- Troop 331
- Chris Leppart: 760-822-6305
Non-prescription Medication
To allow your youth to receive non-prescribed medication, sign below the medication section on page 2 of Form B. You may note exceptions. Without a signature, we cannot give over-the-counter medication like Tylenol, ibuprofen, or antibiotic cream.
Immunizations
For all participants, Tetanus, Pertussis, MMR, Polio, and Chicken Pox are required on the form. These will be specifically checked during Summer Camp or High Adventure check-in. Please fill out your child's immunization information as accurately as possible. Many camps no longer accept "Up to Date" or a crossed-out line in the date fields.
If you or your doctor use MyChart, you can find this information there. All other immunizations are optional to include.
Immunization records are also available from the State of Indiana via MyVaxIndiana
If you or your child is not immunized, a waiver must be attached to the health form and can be found here: Waiver Form.
Form C
Form C must be signed and dated. Before leaving the doctor's office, check that it is complete. Otherwise, you may need to pick up your scout or submit an updated form. Most camps do not accept emailed copies and leaders at camp cannot print forms.
If you have any further questions, please speak to any unit leader.