Health and Medical Forms
In the Longs Peak Council there are several health and medical forms, and each has a different use:
Class 1 Personal Health History - BSA Form #34414A
This form is the front side (and part of the back side) of the Personal Health and Medical Record - Class 1 and Class 2 form. This form is used by district and council activities and outings that do not exceed 72 hours in length.
It may also be used for pack / troop / team/ crew activities so Scout leaders have basic health history information in case an emergency arises during a Scouting activity or outing. This form is kept confidentially with the Scout unit.
A parental permission section is part of this form. The use of this form does not require a medical examination.
Class 2 Medical Evaluation - BSA Form #34414A
This form is on the reverse side of the Personal Health and Medical Record - Class 1 and Class 2 form. This form is used with the Class 1 form when a district or council activity is to exceed 72 hours in length. This form must be signed by a health professional (normally a medical doctor - state requirements may allow another health care practitioner) within the proceeding 36 months of the activity. According to the Colorado Department of Human Services and the Colorado Department of Public Health and Environment, this form is NOT acceptable at camps in the state of Colorado (see below). This form may be used at Camp Laramie Peak.
Class 3 Personal Health and Medical Record Form - BSA Form #34412A
This form is to be used by youth and adult participants in high adventure activities. It is also to be used by all adults age 40 plus for any activity requiring a health examination. This form is required use by all Wood Badge Course participants! According to the Colorado Department of Human Services and the Colorado Department of Public Health and Environment, this form is NOT acceptable for youth members at camps in the state of Colorado (see below). This form may be used at Camp Laramie Peak.
Longs Peak Council (Colorado Approved) Health and Medical Record Form
This form has been approved by the state of Colorado for use at the Ben Delatour Scout Ranch and the Elkhorn High Adventure Base for both youth and adults. It is to be used in place of the Class 1 & 2 combination Form and the Class 3 Form. It should also be accepted at other BSA camps in the state of Colorado. The state of Colorado also requires that a medical examination is to have been conducted within the past 24 months (not 36 months as the BSA requires). This form may be used at Camp Laramie Peak.
Longs Peak Council Jack Nicol Cub Camp Health and Medical Record Form
This form is for use by both youth and adults for programs at the Jack Nicol Cub Camp. A parental permission section is part of this form. The use of this form does not require a medical examination.
National and International BSA Events and Activities
For National Jamborees, World Jamborees, Philmont Scout Ranch, Northern Tier Bases, and the Florida Sea Base the National Office of the BSA normally issues a special health and medical form each activity or event.
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Last Updated Thursday, 30-Jul-2009 14:38:50 MDT