医疗许可书 - 美国巴顿夏季学校.docx

Annual Health and Medical Record年度健康及医疗记录(Valid for 12 calendar months)(12个月有效期)How to complete form:1) Complete entire form leaving no sections empty or blankSubmit by hand, mail or2) Scan entire document3) Send in PDF form to:bartonschools@Policy on Use of the Annual Health and Medical RecordIn order to provide better care for its members and to assist them in better understanding their own physical capabilities, the Boy Scouts of America and Barton Summer Academy recommends that everyone who participate in a Scout-Barton event have an annual medical evaluation by a certified and licensed healthcare provider, a physician (MD or DO), nurse practitioner, or physician assistant. Providing your medical information on this form will help ensure you meet the minimum standards for participation in various activities. Note that unit leaders must always protect the privacy of unit participants by protecting their medical information.This health and medical form are to be completed at least annually by participants in all Scouts-Barton events. This health history, parental/ guardian informed consent and release agreement, and talent release statement is to be completed by the participant and parents/guardians. Attach a copy of both sides of your insurance card.Risk FactorsBased on the vast experience of the medical community, the Scouts-Barton organizations have identified the following risk factors that may be limit your participation in various outdoor adventures.? Excessive body weight? Asthma? Heart disease? Allergies/anaphylaxis? Hypertension? Muscular/skeletal injuries? Diabetes? Psychiatric/psychological and ? Lack of appropriate emotional difficulties ImmunizationsPrescriptionsThe taking of prescription medication is the responsibility of the individual taking the medication and/or that individual’s parent or guardian. A leader, after obtaining all the necessary information, can agree to accept the responsibility of making sure a youth takes the necessary medicati