Medical Record

BSA Annual Health and Medical Record

BSA uses a FOUR (4) part Annual Health and Medical Record form which is required to be used by all scout units.

BSA updated the Annual Health and Medical Record form September 2012, and we will only accept this new form from this date on (as previous forms expire and from new members).

Details and downloads of the latest BSA Med Form can be found here:

Please use the link above to download the latest form. We will no longer save downloaded copies on the Troop website, in an effort to avoid any confusion about the lastest form.

In short, Parts A & B must be filled out by EVERY participant in any Scouting event, this includes, but is not limited to, Scouts, Scouters, Parents/Guardians, siblings and any other persons participating in a Scouting event.

Part C is the physical exam that is required for participants in any event that exceeds 72 consecutive hours, for all high-adventure base participants, or when the nature of the activity is strenuous and demanding. The BSA defines strenuous and demanding as any activity that exceeds that which the person might normally do at home or school.

Part D is required to be reviewed by all participants of a high-adventure program at one of the national high-adventure bases and shared with the examining health-care provider before completing Part C.

Before any activity, it is the responsibility of the Scoutmaster in Charge to check these medical forms to make sure s/he is familiar with any ailment and/or issues which may affect the over-all outcome of the activity or safety of the individuals participating in the activity.

Part B requires parents to designate at least one person and phone number who is authorized to take their youth to and from events, which may include themselves. It also allows them to designate people expressly forbidden to take their youth to and from events. This may cause problems when trying to arrange rides to and from camping trips. We would suggest the parents/guardians list themselves and then list, "Any driver approved by the Troop Committee.”

So what does this mean to YOU?

    • Please complete 3 copies of Parts A and B for all scouts (one for the Troop master binder, one for Patrol binder to go on outings, and one for Summer Camp). KEEP THE ORIGINAL FOR YOUR RECORDS. Please complete only 2 copies for all scouters (registered adults) in your family. (Dads going to summer camp, please provide 3 copies.)Include 3 copies of insurance cards.
    • Take Part C to your doctor at your next physical appointment. KEEP THE ORIGINAL FOR YOUR RECORDS. Turn in three copies! Part C is for events longer than 72 hours, like summer camp.
    • Most members only need parts A, B, and C. Part D is only for those going to Sea Base/Philmont/Northern Tier/Bechtel Summit Reserve.
    • Hate filling these out by hand? Fill them in electronically! Download and save a copy of the file from the link at the top or bottom of this page. SAVE AS with a name it for each member of your family, then you can open your new files and type right into the form! You can download the forms from the bottom of this page.
    • KEEP THE ORIGINAL FOR YOUR RECORDS! (And, it helps you with next year's form...until they change it ;))
    • Please turn in required number of copies of parts A and B for all Scouts and parents as soon as possible.
    • Don’t forget the copies of your insurance cards!
    • Remember to put the note about drivers from above. To help make sure you have everything, use the self-audit sheet below.

It is YOUR responsibility to be aware of expiration dates for Medical forms. Scouts with out of date medical forms will not be able to participate.

Troop 628 Scout Rx and OTC Medication Administration

Troop 628 requires each scout to have a copy of our Scout Prescription and Over-the-Counter Medication Administration Form on file in our medical binder for all outings. If a scout requires any over-the-counter medications, the Scoutmasters will document the administration on that form. This form is available below.

If a scout takes prescription medications, a separate Rx and OTC Med Admin form will need to be filled out for each outing and turned in along with the commitment form. A copy of this form goes out with each commitment form.

Parents must bring prescription medications in a labeled ziplock bag and give them to the scoutmasters prior to departure. All medications must also be labeled with the scout's name and the required dosage and frequency/times.

Summer Camp Medical Forms

Camp Tuckahoe requires a copy of Parts A, B, and C of the BSA Medical form (that's why we ask for 2 copies from you) in addition to its own medical form and its own Medication Administration form.