Annual Health Medical Form

In order to provide better care for its members and to assist them in better understanding their own physical capabilities, the Boy Scouts of America recommends that everyone who participates in a Scouting event have an annual medical evaluation by a certified and licensed health-care provider—a physician (MD or DO), nurse practitioner, or physician assistant. Providing your medical information on this four-page form  will help ensure you meet the minimum standards for participation in various activities.

Parts A and B  are to be completed at least annually by participants in all Scouting events. This health history, parental/guardian informed consent and hold harmless/release agreement, and talent release statement are to be completed by the participant and parents/guardians.  This form is required each year at charter renewal in November.  It is also required for each parent who attends any camp (family camp, day camp, or resident camp).

Part C  is the physical exam that is required for participants in any event that exceeds 72 consecutive hours, for all high-adventure base participants, or when the nature of the activity is strenuous and demanding. Service projects or work weekends may fit this description. Part C is to be completed and signed by a certified and licensed heath-care provider—physician (MD or DO), nurse practitioner, or physician assistant. It is important to note that the height/weight limits must be strictly adhered to when the event will take the unit more than 30 minutes away from an emergency vehicle, accessible roadway, or when the program requires it, such as backpacking trips, high-adventure activities, and conservation projects in remote areas. See the FAQs for when this does not apply. 

You can fill out this form online with Adobe Acrobat Reader and save them to your computer.  Each year, you will then only need to update any changes and re-print with the current date.

BSA Health and Safety Forms 

Volunteer and Leader form found here.