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If so indicate below and sign No immunization No medical examination GSSSC 10/16- CAMP540 HEALTH HISTORY FORM Page 2 of 2. Pseudoephedrine decongestant Diphenhydramine antihistamine Dextromethorphan cough Calamine Lotion anti-itch Antacid Tablets upset stomach ANY PRESCRIPTION and OVER-THE-COUNTER OTC MEDICATIONS YOU ARE SENDING TO CAMP WITH YOUR CAMPER must be in original container with name address of camper pharmacy dosage and frequency. Contact us if you have turned in a health exam...
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