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BASIS SUMMER PROGRAMSHealth History Form STUDENT INFORMATION Student First Name: Student Last Name: Date of birth: Program: CDE MAP Expression: 1st Session 2nd Session 1st & 2nd SessionResidential
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How to fill out summer program health history

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How to fill out summer program health history

01
Obtain the health history form provided by the summer program.
02
Fill out personal information such as name, date of birth, and contact information.
03
Provide details of any medical conditions you may have, including allergies, asthma, or any ongoing treatments.
04
List any medications you are currently taking, including dosage and frequency.
05
Include emergency contact information in case of any medical issues during the program.
06
Sign and date the form to acknowledge that the information provided is accurate and complete.

Who needs summer program health history?

01
Participants enrolled in the summer program
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Summer program health history is a form that collects information about an individual's medical history, current health status, and any necessary medical accommodations needed during a summer program.
All participants attending a summer program are required to file a summer program health history form.
Participants can fill out the summer program health history form by providing accurate and honest information about their medical history, current health status, and any necessary medical accommodations.
The purpose of a summer program health history is to ensure the safety and well-being of participants during the program by providing medical staff with necessary information to address any health concerns that may arise.
Participants must report their medical history, current health status, known allergies, any medications they are taking, and any necessary medical accommodations or restrictions.
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