INFORMATION



TROOP 32routine medical administration recordINFORMATIONName: FORMTEXT ?????Date of Birth: FORMTEXT ?????Drug Allergies: FORMTEXT ?????Weight: FORMTEXT ?????MEDICATIONS AND DOSAGE INSTRUCTIONSPARENT or GUARDIAN: Complete medication name, dosage, frequency (times) for each medication to be administered. This form may not be transmitted via email, fax, text or scan. Parents may make copies, however, the medical information must be current including dosage, frequency, and the Scout’s weight for each campout.ONSITE MEDIC(s): Record the time the medication was given and initial each day and time the medication was administered.All medications, especially controlled substances, will be locked up and administered by the Onsite Medic(s). In the event of a medical emergency, provide this record to emergency personnel.TIME:FRISATSUNMONTUEWEDTHUMedication: FORMTEXT Dosage: FORMTEXT ?????Times: FORMTEXT ?????Notes: FORMTEXT ?????TIME:FRISATSUNMONTUEWEDTHUMedication: FORMTEXT ?????Dosage: FORMTEXT ?????Times: FORMTEXT ?????Notes: FORMTEXT ?????TIME:FRISATSUNMONTUEWEDTHUMedication: FORMTEXT ?????Dosage: FORMTEXT ?????Times: FORMTEXT ?????Notes: FORMTEXT ?????TIME:FRISATSUNMONTUEWEDTHUMedication: FORMTEXT ?????Dosage: FORMTEXT ?????Times: FORMTEXT ?????Notes: FORMTEXT ?????TIME:FRISATSUNMONTUEWEDTHUMedication: FORMTEXT ?????Dosage: FORMTEXT ?????Times: FORMTEXT ?????Notes: FORMTEXT ?????SIGNATURESParent or Guardian: FORMTEXT ?????Onsite Medic(s): FORMTEXT ?????Date Submitted: FORMTEXT ?????Date Received: FORMTEXT ????? ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download