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MI Girl Scouts Heart Medication Record Form 2015-2025 free printable template

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Girl Scouts Heart of Michigan Medication Record Form Not needed unless sending medication to camp This needs to be filled out for ANY medication including over the counter medicine like Tylenol and medications must be given to camp First Aider in original packaging Participants Name Date Location Maybury Day Camp MEDICATION dose route Time to be and frequency given Mon Tues Wed Thurs Fri Parent/Guardian Signature Date.
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How to fill out MI Girl Scouts Heart Medication Record Form

01
Obtain the MI Girl Scouts Heart Medication Record Form from the official website or your Girl Scout leader.
02
Fill in the camper's full name at the top of the form.
03
Enter the date of birth of the camper right below the name.
04
Provide the name of the medication, including dosage and frequency, in the designated section.
05
Specify any allergies or adverse reactions related to the medication.
06
Attach any necessary doctor’s notes or prescriptions as required.
07
Have a parent or guardian sign and date the form to confirm the information is accurate.
08
Submit the completed form to the designated Girl Scouts leader before the event.

Who needs MI Girl Scouts Heart Medication Record Form?

01
Any Girl Scouts camper who requires medication during events or camps.
02
Parents or guardians of campers who need to communicate medication information.
03
Leaders and health personnel responsible for overseeing camper health and safety.
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The MI Girl Scouts Heart Medication Record Form is a document used to record and monitor the administration of heart medications to Girl Scouts participating in programs.
It is required to be filed by any adult leaders, caregivers, or medical personnel responsible for administering heart medications to scouts.
To fill out the form, provide the scout's personal information, specific medication details, dosage, frequency of administration, and any necessary emergency contacts.
The purpose of the form is to ensure the safe administration of heart medications, track dosages given, and provide a reference in case of emergencies.
The information that must be reported includes the scout's name, medication name, dosage, administration times, medical conditions, and names of authorized adults.
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Michigan Tues Thurs Fri Tylenol Maybury Aider Participants packaging medications

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