Health Forms

Troop 737 Parents and Scouts- PLEASE READ CAREFULLY

As we proceed into the new year many of you, scouts and adults, will be getting their health forms filled out by their family health professional. In order to be compliant with these forms, it is important to accurately and completely fill them out. This is the best way for the Troop to keep the scouts and parents safe during Troop events and campouts. Below are sample forms to review so that these forms are filled out per BSA requirements. BSA treats scouts as a “daycare” and therefore guidelines are needed to be followed.

The first sheet is a checklist for the forms that follow it. Checking off each box as you fill out the forms will ensure all forms are filled out completely.

Please note there are some forms that are new to our Troop this year. These include forms for:

  • Copy of insurance card information (front and back of card)
  • Carry/use an inhaler
  • Severe allergies and carry an Epi Pen
  • Immunization exemption request
  • Over-the-Counter(OTC) Medication Dispensation Permission Form.

An important note regarding medications and immunizations

he area for listing medications on the Health Form Part B is for those medications the scout/adult is taking on a daily basis. If the medication is an over the counter medication taken every day, then the medication name, dose and frequency is written here. If it is an over the counter medication taken on an “as needed basis” then please use the OTC form in the packet. Please do add inhalers and Epi Pen, with dose and frequency of use, to this area to make it easier for the HALO to be made aware. Doses of all medications listed in this area must be filled in as well as the frequency. In addition, a doctor/PA/NP signature must be present under medication area. Even if no medications are listed, it is recommended to have the health care professional’s signature there regardless. Any listed medications that are incomplete, will be returned for further clarification. If you have any questions regarding medications, please do not hesitate to ask. Regarding immunizations, it is important that you provide an updated record for the Scout. A copy of the Scout’s immunization record from the doctor’s office will suffice. A Colorado Immunization Form is included should you want to fill that form out. For the adults regarding immunizations, it is required that you provide the date of last tetanus shot. If you choose to be exempt from immunizations please fill out both the middle part of the Colorado Immunization form (requires doctor’s signature) and the Immunization Exemption Request form.

After you complete your forms

Please do not hand in the original forms as you will want to keep them for your records. Once forms are filled out, it is requested that you make 3 copies of all forms and hand to Mr. Plaehn at any meeting. Any incomplete forms will be kindly returned for completion. Please direct any questions to myself and I will be happy to answer them.

Marla Plaehn 303-465-0438

T737 Health Form 2019

Troop 737 Health Forms and Checklist

Powers, Kenny T737 Health Form 2019

Sample Completed Forms