BSA Annual Health & Medical Record
Start at our Quick Tips page for important policies and guides about medical forms.
The below forms are writable PDFs, but save a blank copy to your computer first before filling out if you want the entered data to be saved. Select what you need as indicated in the description. All forms MUST be accompanied by a Health Record Worksheet.
For Troop Activities/Overnight Camping:
Parts A & B: to be completed at least annually by participants in all Scouting events. This health history, parental/guardian informed consent and release agreement, and talent release statement are to be completed by the participant and parents/guardians.
For Summer Camp:
Parts A, B & C: contains the additional physical exam that is required for participants in any event that exceeds 72 consecutive hours or is particularly strenuous. Part C is to be completed and signed by a certified and licensed health-care provider—physician (MD or DO), nurse practitioner, or physician assistant.
Camp Aquehonga/TMR participants: use this complete AQ medical form with OTC/Meningitis form instead of one above. The OTC/Meningitis forms are the only difference and must be submitted as originals.
Onteora Participants: use A,B & C above.
For Specific High-Adventure Trips:
Florida Sea Base: required for Sea Base high-adventure trip. SCUBA participants also require PADI Medical Statement.
Northern Tier: for wilderness canoe treks, and OKPIK winter adventures participants and staff.
Philmont Scout Ranch: for all camping participants and staff.
Philmont Training Center: for Mountain trek, Trailblazers, Mustangs, NAYLE, NAYLE staff, PLC, and PLC participants and staff. PTC conferences and all other family program groups can use the Limited Backcountry Form.
Summit Bechtel Reserve (Annual Scout Jamboree): for all camping participants and staff.
Immunization Exemption Request Form: Adults without any immunization record may use this form.