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The BSA Health Form plays a pivotal role in ensuring the safety and well-being of participants involved in Scouting activities. It contains essential components that encompass informed consent, health history, and medical clearance. Initially, participants provide their personal details, such as full name and date of birth, alongside details of their high-adventure crew or staff position. The informed consent section clarifies the inherent risks associated with Scouting activities, informing parents and participants of the voluntary nature of participation. It also enables the sharing of medical information with appropriate BSA personnel to cater to any special needs. Moreover, the form includes a comprehensive health history, documenting any pre-existing medical conditions, allergies, and current medications. Participants must also undergo a pre-participation physical conducted by certified medical professionals to confirm their fitness for the activities planned. This certification ensures that potential risks are assessed, and any necessary restrictions are documented. Overall, the BSA Health Form is a crucial document that prioritizes participant safety while navigating the adventurous nature of Scouting programs.

Form Sample

Part A: Informed Consent, Release Agreement, and Authorization

A

Full name: ____________________________________________

Date of birth:__________________________________________

High-adventure base participants:

Expedition/crew No.:_ _______________________________________________

or staff position:___________________________________________________

Informed Consent, Release Agreement, and Authorization

I understand that participation in Scouting activities involves the risk of personal injury, including death, due to the physical, mental, and emotional challenges in the activities offered. Information about those activities may be obtained from the venue, activity coordinators, or your local council. I also understand that participation in these activities is entirely voluntary and requires participants to follow instructions and abide by all applicable rules and the standards of conduct.

In case of an emergency involving me or my child, I understand that efforts will be made to contact the individual listed as the emergency contact person by the medical provider and/or adult leader. In the event that this person cannot be reached, permission is hereby given to the medical provider selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for me or my child. Medical providers are authorized to disclose protected health information to the adult in charge, camp medical staff, camp management, and/or any physician or health-care provider involved in providing medical care to the participant. Protected Health Information/Confidential Health Information (PHI/CHI) under the Standards for Privacy of Individually Identifiable Health Information, 45 C.F.R. §§160.103, 164.501, etc. seq., as amended from time to time, includes examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant’s parents or guardian, and/or determination of the participant’s ability to continue in the program activities.

(If applicable) I have carefully considered the risk involved and hereby give my informed consent for my child to participate in all activities offered in the program. I further authorize the sharing of the information on this form with any BSA volunteers or professionals who need to know of medical conditions that may require special consideration in conducting Scouting activities.

With appreciation of the dangers and risks associated with programs and activities, on my own behalf and/or on behalf of my child, I hereby fully and completely release and waive any and all claims for personal injury, death, or loss that may arise against the Boy Scouts of America, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with any program or activity.

I also hereby assign and grant to the local council and the Boy Scouts of America, as well as their authorized representatives, the right and permission to use and publish the photographs/film/ videotapes/electronic representations and/or sound recordings made of me or my child at all Scouting activities, and I hereby release the Boy Scouts of America, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all liability from such use and publication. I further authorize the reproduction, sale, copyright, exhibit, broadcast, electronic storage, and/or distribution of said photographs/film/videotapes/electronic representations and/or sound recordings without limitation at the discretion of the BSA, and I specifically waive any right to any compensation I may have for any of the foregoing.

Every person who furnishes any BB device to any minor, without the express or implied permission of the parent or legal guardian of the minor, is guilty of a misdemeanor. (California Penal Code

Section 19915[a]) My signature below on this form indicates my permission.

I give permission for my child to use a BB device. (Note: Not all events will include BB devices.)

Checking this box indicates you DO NOT want your child to use a BB device.

NOTE: Due to the nature of programs and activities, the Boy Scouts of America and local councils cannot continually monitor compliance of program participants or any limitations imposed upon them by parents or medical providers. However, so that leaders can be as familiar as possible with any limitations, list any restrictions imposed on a child participant in connection with programs or activities below.

List participant restrictions, if any: None

________________________________________________________

I understand that, if any information I/we have provided is found to be inaccurate, it may limit and/or eliminate the opportunity for participation in any event or activity. If I am participating at Philmont Scout Ranch, Philmont Training Center, Northern Tier, Sea Base, or the Summit Bechtel Reserve, I have also read and understand the supplemental risk advisories, including height and weight requirements and restrictions, and understand that the participant will not be allowed to participate in applicable high-adventure programs if those requirements are not met. The participant has permission to engage in all high-adventure activities described, except as specifically noted by me or the health-care provider. If the participant is under the age of 18, a parent or guardian’s signature is required.

Participant’s signature:_____________________________________________________________________________________________ Date:_ ______________________________

Parent/guardian signature for youth:___________________________________________________________________________________ Date:_ ______________________________

(If participant is under the age of 18)

Complete this section for youth participants only:

Adults Authorized to Take Youth to and From Events:

You must designate at least one adult. Please include a phone number.

Name: __________________________________________________________________

Name: __________________________________________________________________

Phone: __________________________________________________________________

Phone: __________________________________________________________________

Adults NOT Authorized to Take Youth to and From Events:

Name: __________________________________________________________________

Name: __________________________________________________________________

Phone: __________________________________________________________________

Phone: __________________________________________________________________

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2019 Printing

Part B1: General Information/Health History

Full name: ____________________________________________

Date of birth:__________________________________________

B1

High-adventure base participants:

Expedition/crew No.:_ _______________________________________________

or staff position:___________________________________________________

Age:_ ____________________________ Gender:_ __________________________ Height (inches):_ ___________________________ Weight (lbs.):_____________________________

Address:__________________________________________________________________________________________________________________________________________

City:_ ___________________________________________ State:_____________________________ ZIP code:_ __________________ Phone:_______________________________

Unit leader:_____________________________________________________________________________ Unit leader’s mobile #:_________________________________________

Council Name/No.:________________________________________________________________________________________________________Unit No.:_____________________

Health/Accident Insurance Company:_ ________________________________________________________ Policy No.:____________________________________________________

Please attach a photocopy of both sides of the insurance card. If you do not have medical insurance, enter “none” above.

In case of emergency, notify the person below:

Name:_______________________________________________________________________________Relationship:____________________________________________________

Address: _________________________________________________________________ Home phone:_ _________________________ Other phone:_ _________________________

Alternate contact name:__________________________________________________________________ Alternate’s phone:_______________________________________________

Health History

Do you currently have or have you ever been treated for any of the following?

Yes

No

Condition

 

Explain

 

 

Diabetes

Last HbA1c percentage and date:

Insulin pump: Yes £ No £

 

 

 

 

 

 

 

Hypertension (high blood pressure)

 

 

 

 

 

 

 

 

 

Adult or congenital heart disease/heart attack/chest pain (angina)/

 

 

 

 

heart murmur/coronary artery disease. Any heart surgery or

 

 

 

 

procedure. Explain all “yes” answers.

 

 

 

 

 

 

 

 

 

Family history of heart disease or any sudden heart-related

 

 

 

 

death of a family member before age 50.

 

 

 

 

 

 

 

 

 

Stroke/TIA

 

 

 

 

 

 

 

 

 

Asthma/reactive airway disease

Last attack date:

 

 

 

 

 

 

 

 

Lung/respiratory disease

 

 

 

 

 

 

 

 

 

COPD

 

 

 

 

 

 

 

 

 

Ear/eyes/nose/sinus problems

 

 

 

 

 

 

 

 

 

Muscular/skeletal condition/muscle or bone issues

 

 

 

 

 

 

 

 

 

Head injury/concussion/TBI

 

 

 

 

 

 

 

 

 

Altitude sickness

 

 

 

 

 

 

 

 

 

Psychiatric/psychological or emotional difficulties

 

 

 

 

 

 

 

 

 

Neurological/behavioral disorders

 

 

 

 

 

 

 

 

 

Blood disorders/sickle cell disease

 

 

 

 

 

 

 

 

 

Fainting spells and dizziness

 

 

 

 

 

 

 

 

 

Kidney disease

 

 

 

 

 

 

 

 

 

Seizures or epilepsy

Last seizure date:

 

 

 

 

 

 

 

 

Abdominal/stomach/digestive problems

 

 

 

 

 

 

 

 

 

Thyroid disease

 

 

 

 

 

 

 

 

 

Skin issues

 

 

 

 

 

 

 

 

 

Obstructive sleep apnea/sleep disorders

CPAP: Yes £ No £

 

 

 

 

 

 

 

 

List all surgeries and hospitalizations

Last surgery date:

 

 

 

 

 

 

 

 

List any other medical conditions not covered above

 

 

 

 

 

 

 

680-001

2019 Printing

Part B2: General Information/Health History

Full name: ____________________________________________

Date of birth:__________________________________________

B2

High-adventure base participants:

Expedition/crew No.:_ _______________________________________________

or staff position:___________________________________________________

Allergies/Medications

DO YOU USE AN EPINEPHRINEYES NO

AUTOINJECTOR? Exp. date (if yes) ___________________________

Are you allergic to or do you have any adverse reaction to any of the following?

Yes

No

Allergies or Reactions

Explain

 

 

 

 

Medication

Food

DO YOU USE AN ASTHMA RESCUEYES NO

INHALER? Exp. date (if yes) ___________________________________

Yes

No

Allergies or Reactions

Explain

 

 

 

 

 

 

Plants

 

 

 

 

 

 

 

Insect bites/stings

 

 

 

 

 

List all medications currently used, including any over-the-counter medications.

Check here if no medications are routinely taken.

If additional space is needed, please list on a separate sheet and attach.

Medication

Dose

Frequency

Reason

YES NO

Non-prescription medication administration is authorized with these exceptions:_________________________________________________________________

Administration of the above medications is approved for youth by:

_______________________________________________________________________ /________________________________________________________________________

Parent/guardian signature

MD/DO, NP, or PA signature (if your state requires signature)

Bring enough medications in sufficient quantities and in the original containers. Make sure that they are NOT expired, including inhalers and EpiPens. You SHOULD NOT STOP taking any maintenance medication unless instructed to do so by your doctor.

Immunization

The following immunizations are recommended. Tetanus immunization is required and must have been received within the last 10 years. If you had the disease, check the disease column and list the date. If immunized, check yes and provide the year received.

Yes

No

Had Disease

Immunization

Date(s)

 

 

 

 

 

Tetanus

Pertussis

Diphtheria

Measles/mumps/rubella

Polio

Chicken Pox

Hepatitis A

Hepatitis B

Meningitis

Influenza

Other (i.e., HIB)

Exemption to immunizations (form required)

Please list any additional information about your medical history:

_________________________________________

_________________________________________

_________________________________________

_________________________________________

DO NOT WRITE IN THIS BOX.

Review for camp or special activity.

Reviewed by:_ ___________________________________________

Date:_ _________________________________________________

Further approval required: YesNo

Reason:_ _______________________________________________

Approved by:____________________________________________

Date:_ _________________________________________________

680-001

2019 Printing

Part C: Pre-Participation Physical

This part must be completed by certified and licensed physicians (MD, DO), nurse practitioners, or physician assistants.

C

Full name: ____________________________________________

Date of birth:__________________________________________

High-adventure base participants:

Expedition/crew No.:_ _______________________________________________

or staff position:___________________________________________________

You are being asked to certify that this individual has no contraindication for participation in a Scouting experience. For individuals who will be attending a high-adventure program, including one of the national high-adventure bases, please refer to the supplemental information on the following pages or the form provided by your patient. You can also visit www.scouting.org/health-and-safety/ahmr to view this information online.

Please fill in the following information:

 

 

 

 

 

 

 

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

Explain

 

 

Medical restrictions to participate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

No

 

 

Allergies or Reactions

 

Explain

 

 

Yes

 

No

 

 

Allergies or Reactions

 

 

Explain

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medication

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Plants

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Insect bites/stings

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Height (inches)

 

 

 

Weight (lbs.)

 

BMI

 

 

 

 

Blood Pressure

 

 

Pulse

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Normal

Abnormal

 

Explain Abnormalities

Examiner’s Certification

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I certify that I have reviewed the health history and examined this person and find

no contraindications for

 

 

 

 

 

 

 

 

 

 

 

 

 

Eyes

 

 

 

 

 

 

 

 

 

 

 

participation in a Scouting experience. This participant (with noted restrictions):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

True

 

False

 

 

 

Explain

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ears/nose/throat

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Meets height/weight requirements.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Lungs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Has no uncontrolled heart disease, lung disease, or hypertension.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Has not had an orthopedic injury, musculoskeletal problems, or orthopedic

Heart

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

surgery in the last six months or possesses a letter of clearance from his or her

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

orthopedic surgeon or treating physician.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Has no uncontrolled psychiatric disorders.

 

 

Abdomen

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Has had no seizures in the last year.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Genitalia/hernia

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Does not have poorly controlled diabetes.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If planning to scuba dive, does not have diabetes, asthma, or seizures.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Musculoskeletal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Examiner’s signature:_ _______________________________________ Date: _ _______________

Neurological

 

 

 

 

 

 

 

 

 

Examiner’s printed name:_ _________________________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:________________________________________________________________________

Skin issues

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City:_ ______________________________________State:_ ______________ ZIP code:_ _________

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Office phone:____________________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Height/Weight Restrictions

If you exceed the maximum weight for height as explained in the following chart and your planned high-adventure activity will take you more than 30 minutes away from an emergency vehicle/ accessible roadway, you may not be allowed to participate.

Maximum weight for height:

Height (inches)

Max. Weight

 

Height (inches)

Max. Weight

Height (inches)

Max. Weight

 

Height (inches)

Max. Weight

 

 

 

 

 

 

 

 

 

 

 

60

166

65

195

 

70

226

75

260

 

 

 

 

 

 

 

 

 

 

 

61

172

66

201

 

71

233

76

267

 

 

 

 

 

 

 

 

 

 

 

62

178

67

207

 

72

239

77

274

 

 

 

 

 

 

 

 

 

 

 

63

183

68

214

 

73

246

78

281

 

 

 

 

 

 

 

 

 

 

 

64

189

69

220

 

74

252

 

79 and over

295

 

 

 

 

 

 

 

 

 

 

 

680-001

2019 Printing

Document Specifications

Fact Name Details
Purpose The BSA Health Form ensures that participants in Scouting activities are aware of potential risks and provides necessary medical information to leaders.
Informed Consent Participants must acknowledge and accept the risks associated with physical, mental, and emotional challenges within Scouting activities.
Emergency Contact Each participant designates an emergency contact, allowing medical providers to reach out in the event of an emergency.
Protected Health Information Medical providers can share health information among involved parties, adhering to U.S. privacy standards outlined in 45 C.F.R. §§160.103, 164.501.
Legal Authorization The form allows for the medical treatment of participants without contacting the emergency contact, should they be unreachable.
Photograph Release Participants give permission for their images to be published, waiving any claims related to the use of photographs or recordings.
Disclaimer for BB Devices California law states that providing a BB device to a minor without parental consent is a misdemeanor (Cal. Penal Code §19915(a)).
Health History Required A comprehensive health history section gathers essential medical information, including conditions like diabetes or allergies, for participant safety.
State-Specific Laws Each state may have specific requirements regarding parental consent and health history disclosures. Review local regulations applicable to the BSA Health Form.

Steps to Filling Out Bsa Health

Completing the BSA Health form is an important step that ensures all necessary health information is collected for participants in Scouting activities. The form contains several sections that must be filled out, including personal details, health history, and emergency contacts. It is important to provide accurate information to facilitate a safe experience during the events.

  1. Begin by filling out Part A: Informed Consent, Release Agreement, and Authorization. Write the full name and date of birth of the participant.
  2. Indicate the expedition or crew number or the staff position.
  3. Read the Informed Consent section carefully, then sign and date the form. If the participant is under 18, a parent or guardian must also sign.
  4. If applicable, list any restrictions imposed on the participant regarding their participation in programs or activities.
  5. Provide information in Part B1: General Information/Health History. Fill in the participant's full name, date of birth, age, gender, height, and weight.
  6. Enter the address, city, state, and ZIP code of the participant, along with a contact phone number.
  7. Complete details about the unit leader and provide the council name and number, as well as the unit number.
  8. Add the name of the health/accident insurance company and the policy number; attach a photocopy of the insurance card if available.
  9. In case of an emergency, provide the name and contact details of an individual who should be notified.
  10. Complete the health history section by indicating any relevant medical conditions or allergies, explaining each when required.
  11. Fill out Part B2: General Information/Health History, covering any allergies to medications or foods and listing current medications. Indicate if a parent/guardian has approved any non-prescription medication administration.
  12. Detail the participant's immunizations, checking the appropriate boxes, and list any additional medical history information.
  13. Move to Part C: Pre-Participation Physical. This section must be completed by a licensed healthcare provider. Supply the participant's demographic and health information as requested.
  14. Ensure that the healthcare provider completes the required assessment and certifies that the participant has no contraindications for participation.
  15. Finally, review the form for completeness, and ensure all signatures are included before submission.

More About Bsa Health

What is the BSA Health Form and why is it necessary?

The BSA Health Form is a comprehensive document that collects vital information about participants in Scouting activities, particularly those involving high-adventure programs. This form is essential as it ensures that scouts, leaders, and medical personnel are aware of any existing health conditions and medical history that could impact participation. It not only assists in emergency situations but also helps in maintaining a safe environment during activities.

Who is required to complete the BSA Health Form?

All participants, whether youth or adult, involved in any Scout activities, especially high-adventure programs, must complete the BSA Health Form. For youth participants under 18 years of age, a parent or guardian must also sign the form. This dual completion guarantees that both the individual's personal details and parental consent are adequately documented.

What information is included in the BSA Health Form?

The form encompasses three main sections: Part A gathers informed consent and release agreements; Part B collects general health information and medical history; Part C requires a physical examination completed by a licensed medical professional. Each section is critical for understanding the participant's health status and ensuring safety during activities.

What happens if there's an emergency during a Scouting activity?

In the event of an emergency, efforts will be made to contact the designated emergency contact listed on the form. If this person cannot be reached, the adult leader can authorize medical treatment. This stipulation emphasizes the importance of providing accurate and up-to-date contact information.

How does the BSA Health Form protect personal health information?

The BSA Health Form contains strict confidentiality measures as outlined under the Standards for Privacy of Individually Identifiable Health Information. Participants must consent to share their Protected Health Information (PHI) with relevant parties, such as camp medical staff or adult leaders. This sharing is crucial for ensuring appropriate medical attention while balancing privacy concerns.

Can participants with existing health conditions still participate?

Yes, participants with pre-existing health conditions can still engage in Scouting activities as long as their conditions are disclosed on the BSA Health Form. It is essential for the adult leaders to be aware of these conditions to provide the necessary support and modifications during activities.

What should parents know about the BB device authorization?

Parents need to know that the BSA Health Form includes a section about the use of BB devices. While participation in BB-related activities may not be mandatory, parents must indicate whether they give their consent for their child to use such a device. If consent is not provided, leaders will ensure that the child does not engage in BB-related activities.

What if a participant's health information changes after submitting the form?

If there are any changes to a participant's health information after the form has been submitted, it is crucial to update that information as soon as possible. Not doing so could limit the participant's opportunity for safe engagement in activities and could pose risks to their health during participation.

Where can I find additional information about the BSA Health Form?

Further details about the BSA Health Form, including more specific guidelines about the high-adventure programs, can be found on the official Boy Scouts of America website. It's a great resource to ensure both participants and parents feel confident and informed about the requirements and procedures related to health and safety in Scouting activities.

Common mistakes

  1. Incomplete Personal Information: Participants often neglect to fill in all required personal details, such as the full name, date of birth, and expedition or crew number. This information is crucial for identification and emergency situations.

  2. Missing Emergency Contact Information: Failing to provide an emergency contact can lead to serious issues if medical attention is needed. Always ensure that the contact person’s phone number is included.

  3. Overlooking Health History: It’s important to accurately report any past medical conditions or treatments. Participants sometimes omit details like diabetes, asthma, or previous surgeries, which could affect their ability to participate safely.

  4. Failing to Sign the Form: Parents or guardians often forget to sign the form when the participant is under 18. Without a signature, the form is incomplete and may not be accepted.

  5. Insufficient Medication Information: If participants take medications, they must provide a complete list, including dosages and reasons for taking them. Neglecting this can lead to medical complications.

  6. Ignoring Immunization Requirements: Some individuals may not check the immunization history thoroughly. Missing a current tetanus shot, for instance, can disqualify participation in some events.

  7. Not Disclosing Allergies: Participants sometimes forget to mention allergies, particularly to medication or food. This oversight can pose significant risks during events or activities.

  8. Inconsistent Information: Providing contradictory information in different sections of the form can raise red flags. Make sure the health history is consistent throughout the document to avoid complications.

Documents used along the form

In conjunction with the BSA Health Form, several other documents are commonly required to ensure the safety and well-being of participants. Each of these forms serves a unique purpose in the context of health and safety for those involved in scouting activities. Here’s a summary of five essential documents often used together with the BSA Health Form.

  • Parent/Guardian Consent Form: This document is designed to secure permission from a parent or guardian, confirming they allow a minor to participate in scouting activities. It outlines the specific activities involved, as well as any inherent risks associated with them.
  • Emergency Contact Form: This form collects important information on whom to contact in case of an emergency. It typically requires names, phone numbers, and relationships of individuals designated as emergency contacts for the participant.
  • Medication Authorization Form: This document outlines any medications a participant may need to bring and specifies their usage during scouting events. It includes fields for signatures from parents or guardians to approve the administration of medications by camp staff.
  • Release of Liability Form: Participants or their guardians sign this form to acknowledge understanding of risks involved in scouting activities. It releases the Boy Scouts of America and associated parties from legal claims arising from any accidents or injuries sustained during participation.
  • Insurance Information Form: This form requires details of the participant's health insurance coverage, including the provider's name and policy number. It ensures that emergency medical services are streamlined for the participant and that financial responsibilities are clear.

Each of these documents plays a crucial role in the overall safety protocol for scouting activities. Together with the BSA Health Form, they create a comprehensive health and safety framework that helps ensure a positive experience for all participants.

Similar forms

The BSA Health Form is similar to a general Medical Consent Form. Both documents serve the purpose of obtaining informed consent from a parent or guardian before a minor participates in an event or activity. They often include sections that detail potential risks involved, authorization for medical treatment in case of an emergency, and the release of liability for the organizing body. Both forms prioritize safety and ensure that responsible adults are informed about medical needs related to participants, aiding in providing appropriate care and support during the activities.

Another document with similar functions is the Emergency Contact Form. An Emergency Contact Form collects vital information about who should be contacted in case of an emergency concerning a participant. Like the BSA Health Form, it requires the identification of alternate contacts, helping event leaders ensure that someone responsible can be reached swiftly if needed. This form ultimately supports clear communication during emergencies, which is also a key aspect of the BSA Health Form.

A Field Trip Permission Slip bears resemblance to the BSA Health Form as both require signatures from a parent or guardian for approval. These forms are intended to inform caregivers about the nature of the activities involved. They often emphasize the responsibilities parents assume when granting permission for their children to take part in potentially risky experiences. Just like the BSA Health Form, they may include specific risks related to activities and outline the extent of liability carried by the organizers.

The School Health Record is another comparable document. This type of record documents a student's medical history and current health status. Much like the BSA Health Form, it requires detailed information about preexisting conditions, allergies, and medications that may impact a student's participation in school activities. Both forms actively ensure that adults overseeing the participants are well-informed about individual health needs, thereby promoting a safer environment.

Informed Consent Forms, typically utilized in research or medical settings, share similarities with the BSA Health Form as both seek to inform participants or guardians of potential risks before participation. These forms explain the purpose of the activity, possible hazards, and the nature of the consent being given. The emphasis on understanding risks parallels that found in the BSA Health Form, highlighting the importance of transparency and informed decision-making for participants and their families.

Similarly, an Insurance Release Form outlines terms under which a participant is covered by health insurance. This document, bearing relevance to the BSA Health Form, gathers information on insurance providers and policies in case medical treatment is necessary. Both forms emphasize the availability of insurance, which is crucial when engaging in activities that may pose risks to health and safety.

Lastly, a Sports Physical Form is akin to the BSA Health Form in that both require an assessment by a medical professional before a participant can join physically demanding activities. The Sports Physical Form includes an examination of vital health aspects, evaluating fitness levels, and ensuring that the participant is fit for the respective sport. Like the BSA Health Form, this document aims to identify any potential health risks that could arise from physical exertion, allowing leaders to make informed decisions regarding participation.

Dos and Don'ts

When filling out the BSA Health form, there are several important guidelines to keep in mind. Here are six key do's and don'ts that can help ensure the process goes smoothly.

  • Do read the entire form carefully before starting. Understanding the information required will help avoid mistakes.
  • Do provide complete and accurate details. This includes your full name, date of birth, and medical history.
  • Do check for any required signatures. Make sure both the participant and parent or guardian sign where necessary.
  • Do attach photocopies of insurance cards if applicable. This is crucial for emergency situations.
  • Don’t skip questions regarding medical conditions and allergies. Providing this information is essential for safe participation.
  • Don’t submit the form without reviewing it for accuracy. Mistakes may lead to complications in participation.

By following these guidelines, you can help ensure that the form is filled out thoughtfully and accurately. This will support a safer and more enjoyable experience for all involved.

Misconceptions

Below are common misconceptions regarding the BSA Health Form. Understanding these points is crucial for safe and effective participation in scouting activities.

  • The BSA Health Form is optional. This form is a mandatory requirement for all participants to ensure their safety during activities.
  • Completing the health form is a one-time task. The form must be updated whenever there are changes in medical history or personal information.
  • Providing accurate medical history is not important. Inaccurate information may prevent participation in activities, especially if medical emergencies arise.
  • Only children need to fill out the form. Adults involved in the activities also need to complete the health form for safety purposes.
  • The information is not kept confidential. The contents of the health form are protected and shared only with those who need to know in case of an emergency.
  • Your insurance information is not necessary. Providing insurance details ensures that participants can receive medical treatment without delays.
  • Participation does not require a physician's approval. Certain activities necessitate a physical exam conducted by a licensed medical provider.
  • Restrictions on participation can be ignored. Any restrictions listed should be taken seriously, as they directly impact safety standards during activities.
  • The health form is only relevant in high-adventure activities. All scouting activities, regardless of intensity, require the health form to address potential risks.

Clearing up these misconceptions will enhance the experience for all participants and ensure a safer environment.

Key takeaways

Filling out the BSA Health form is an essential part of ensuring a safe and enjoyable experience for participants. Here are six key takeaways to keep in mind when completing and utilizing this important document:

  • Understand the importance of informed consent: The form emphasizes that participation in scouting activities carries inherent risks. It is crucial to comprehend these risks and provide informed consent for your child’s participation.
  • Emergency contact details: Include the contact information for someone who can be reached in case of an emergency. This can significantly expedite care if needed during an event.
  • Health history matters: Be thorough in reporting your child's health history, including any allergies or medical conditions. This information helps coordinators understand how to support participants effectively.
  • Documentation of medical insurance: Attach a photocopy of both sides of the health insurance card and ensure that any necessary information about coverage is complete. This can streamline the medical treatment process if needed.
  • High-adventure activities: Review the specific requirements for high-adventure activities carefully, as there may be height and weight restrictions. Ensure that your child meets these criteria to avoid any issues on-site.
  • Permission and authorizations: Provide clear permissions regarding the use of BB devices and any public photos taken during events. This helps in safeguarding your child's privacy and ensuring compliance with BSA policies.

By keeping these takeaways in mind, both participants and their guardians can foster a safer and more positive scouting experience.