Summer Camp Medical Log
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1Summer Camp Medical Log
Log Date:____/____/_______
Camp Name:_______________________________________________________________________________
CAMIS/RECORD ID #:________________
Health
Date and
Name of Injured
Date and
Dept.
Injury / Illness or
Time
Person (Child, Staff,
Time of
Location and Activity
Diagnosis and Treatment
Notified
Reported
Other)
Incident
Complaint
(Y/N)
DCR 22 – Summer Camp Medical Log
Rev. 12/18/2013
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