The Boy Scouts of America has released a new Annual Health and Medical Record, a new one stop medical record for your use. This new form will replace the former Class 1, 2, and 3 forms, which will be phased out during 2009. The new form, No. 34605, will be required effective January 1, 2010, and for the 2010 National Scout Jamboree.
Links to download the new form are below.
The form consists of three parts:
Parts A and C are to be completed annually by all BSA unit members. Both parts are required for all events that do not exceed 72 consecutive hours, where the level of activity is similar to that normally expended at home or at school, such as day camp, day hikes, swimming parties, or an overnight camp, and where medical care is readily available. Medical information required includes a current health history and list of medications. Part C also includes the parental informed consent and hold harmless/release agreement (with an area for notarization if required by your state) as well as a talent release statement. Adult unit leaders should review participants’ health histories and become knowledgeable about the medical needs of the youth members in their unit. This form is to
be filled out by participants and parents or guardians and kept on file for easy reference.
Part B is required with parts A and C for any event that exceeds 72 consecutive hours, a resident camp setting, or when the nature of the activity is strenuous and demanding, such as service projects, work weekends, or high-adventure treks. It is to be completed and signed by a certified and licensed health-care provider—physician (MD, DO), nurse practitioner, or physician’s assistant as appropriate for your state. The level of activity ranges from what is normally expended at home or at school to strenuous activity such as hiking and backpacking. Other examples include tour camping, jamborees, and Wood Badge training courses. It is important to note that the height/weight chart must be strictly adhered to if the event will take the unit beyond a radius wherein emergency evacuation is more than 30 minutes by ground transportation, such as backpacking trips, high-adventure activities, and conservation projects in remote areas.
The new pdf version of the form can be filled out on your computer and saved for future updates. It comes with warnings against units emailing or saving electronically the forms.
A few snippets from the Frequently Asked Questions (FAQs):
Q. What are the major changes?
A. A health history is still sufficient for typical activities lasting less than 72 hours (Parts A and C of the new form—similar to the old Class 1 form). For activities lasting longer than 72 hours, a medical evaluation by a health-care provider is now required annually (Part B). For high-adventure activities for which medical care may be delayed, restrictions based on standardized height/weight ratios are now mandatory.
Q. When does the Annual Health and Medical Record go into effect?
A. Everyone should begin using the Annual Health and Medical Record immediately. The existing stock of Class 1, 2, and 3 forms can continue to be used while supplies last in 2009. The only supported form effective January 1, 2010, is the Annual Health and Medical Record. Its use will be mandatory for the 2010 National Scout Jamboree.
Q. How often will I need to renew/update my Annual Health and Medical Record?
A. This form will need to be updated annually, just as many schools or sporting leagues require an annual update. Many changes can happen throughout a year, including changes in disease processes, medication, address, and insurance.
Q. Why do I need to put my child’s or my own social security number on the record?
A. It is your choice as to whether you fill in this number; however, in many states, medical care cannot be rendered without it.
Read the rest of the Frequently Asked Questions (FAQs).
The new forms come in two printing styles:
– Annual Health and Medical Record (Prints on four 8.5 x 11 sheets)
– Annual Health and Medical Record spread (Prints on two 8.5 x 11 sheets)
The new Annual Health and Medical Record cites two additional forms:
– Immunization Exemption Request – Request for exemption from tetanus immunization requirement.
– Medical Care Exemption Request – Request for exemption from medical care.
Both of which, according to the Scouting Safely section of the National Council website, will be coming soon.