Bsa Pre-Camp Health Status Questionnaire printable pdf download

Atlanta Area Council BSA

Health and Safety Committee

Pre-camp Health Status Questionnaire

Date: ____________________ Name of Camp/Activity: ___________________________

Unit Type/Number: ____________________ Home Council: _________________________

Leader Name (who completed the form): ________________________________________

Important:

Leaders (to the best of their ability) will be asked to verify the Health Forms and Histories

have been reviewed and all medications accurately listed. Be prepared to turn in the Pre-

Camp Health Assessment upon arrival at camp.

Instructions:

Prior to attending camp, we request that each unit leader review/ask the following

questions with all of your unit adults and youth. We request that you do this prior to

departing your home location. We will review this procedure upon arrival at camp.

Assessing the Health Status of Your Unit/Campers

Ask the following questions, does this apply to anyone in your unit?

1. Fever (100°F or greater)? . . . . . . . . . . .

o Yes

o No

2. Sore throat? . . . . . . . . . . . . . . . . . . . . .

o Yes

o No

3. Vomiting?. . . . . . . . . . . . . . . . . . . . . . . .

o Yes

o No

4. Diarrhea? . . . . . . . . . . . . . . . . . . . . . . . .

o Yes

o No

5. Cough? . . . . . . . . . . . . . . . . . . . . . . . . .

o Yes

o No

6. Muscle aches or lethargy? . . . . . . . . . . . .

o Yes

o No

Notes:

If an individual in the unit checked "yes" for fever or vomiting or diarrhea alone OR to any

two (or more) of the other symptoms, do not allow that individual to travel to camp. If

they have questions about the individual’s health or symptoms, contact their healthcare

provider.

If any individual has been diagnosed by a healthcare provider with a different disease –

such as strep – have them follow their healthcare provider's recommendation.

Scout Camps are adventurous, active and frequently wilderness environments. There is no

provision for lodging other than in a un-air conditioned tent. Please assure the health and

safety of all of our campers by assuring that only Scouts and Scouters who are healthy

come to camp.

2014‐PrecampHealthStatusQuestionnaire‐020114.doc

Bsa Pre-Camp Health Status Questionnaire

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