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Longs Peak Council

Boy Scouts of America

Health and Medical Forms

* BSA Annual Health and Medical Form

The Boy Scouts of America recommends that all youth and adult members have annual medical evaluations by a certified and licensed health-care provider. In an effort to provide better care to those who may become ill or injured and to provide youth members and adult leaders a better understanding of their own physical capabilities, the Boy Scouts of America has established minimum standards for providing medical information prior to participating in various activities. Those standards are offered below in one three-part medical form. Note that unit leaders must always protect the privacy of unit participants by protecting their medical information.

Parts A and B

Parts A and B (form) are to be completed at least annually by participants in all Scouting events. This health history, parental/guardian informed consent and hold harmless/release agreement, and talent release statement is to be completed by the participant and parents/guardians.

Part C

Part C is required with parts A and B (form) for any event that exceeds 72 consecutive hours, or when the nature of the activity is strenuous and demanding, such as a high-adventure trek.

(Part D - Obsolete - see High Adventure note below)

More Information from the BSA

For more detailed information, please see the Annual Health and Medical Record page of the BSA's Scouting Safely web site.

* High Adventure Activities

Participants at the Longs Peak Council's Elkhorn High Adventure Base should continue to use the old BSA Health and Medical Form Part D along with the new BSA Form Parts A, B and C.

All participants in a high-adventure program at one of the BSA's National High Adventure Bases must use the Base-specific Forms and Risk Advisory. See the see the BSA's Annual Health and Medical Record page for links to these forms.


* Colorado Certificate of Immunization, Exemptions and Other Authorizations

This form is no longer required when using the newest (2014 or later) version of the standard BSA Health and Medical Forms.
This form is required by the Colorado Department of Health and the Environment for any event (such as summer camp) in Colorado that exceeds 72 consecutive hours. It is required of both youth and adult participants.

The form has 3 parts on one page:

  • Approved Alternate Certificate of Immunization - Your Immunization Record
  • Statement of Exemption to Immunization Law - for Medical, Religious or Personal Reasons
  • Parent/Guardian Authorizations
    • Authorization for other persons to take scout from camp.
    • Authorization for off-camp excursions.
    • Activity Restrictions
    • Permission for child to carry an Epi Pen or Inhaler

En Espanól - Certificado de Inmunización y Padre / Tutor Autorizaciones - also available in Spanish.


* Summary of Forms Needed for Scouting in the Longs Peak Council

Note - If you used the older forms and they are still up-to-date (within 12 months of event, and including the Colorado Immunization form for Colorado Boy Scout Camps), you can use them for 2014 camps and through March 2015 for other scouting activities.

For more detailed information about the forms, please see the Annual Health and Medical Record page of the BSA's Scouting Safely web site. En Espanól - Registro Médico y de Salud Anual


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