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Health Forms

All scouts are required to turn in the BSA Annual Health and Medical Record form and a copy of their medical insurance card annually.

Click here to download the BSA Annual Health and Medical Record.

There are several parts to the form. 

  • Part A and Part B
    • Fill out Part A and Part B for scouts and for participating parents.
    • All scouts and adults must turn in Parts A & B before they can go on any troop activity.
  • Part C
    • Filled out by your Doctor
    • Required before a scout or an adult can participate in outings over 72 hours
    • Required for summer camps (e.g. Camp Oljato or Camp Emerald Bay)
    • Required for high-adventure bases (e.g. Philmont, "Northern Tier"). (High-adventure participants also need their doctor to complete Part D)
    • NOTE: New first year scouts don't need to turn in Part C right away, but will need to do so for summer activities.

Here is your step-by-step guide and deadlines to turn in the medical forms.
  1. Fill in Parts A & B on an annual basis. The medical forms coordinator or an activity coordinator will contact you if your form has expired.
  2. Please plan to turn-in Part C of the medical form by May 1st at the very latest. Make your doctor appointment early so you don’t get stuck too close to the deadline.
  3. Copy both sides (front and back) of your insurance card onto one page.
  4. Finally, send the forms and insurance card copy to the medical forms coordinator, via mail, email, or hand it in, in person, at a meeting. Please note that email is not entirely secure unless encrypted, so it is your choice if you wish to email them back.
    • For email, scan all forms and the insurance card copy, save as a PDF, and email the file to the email address below.
    • For regular mail, use mailing address below.
    • NOTE: Please DO NOT staple the forms! Many finger nails have paid the price in undoing the staples!!
    • NOTE: Forms MUST be completed prior to your first outing with the troop

Stephanie Schachter is the Troop 33 Medical Forms Coordinator. You can hand in the medical forms and copy of the insurance card to Stephanie in person, or email or snail mail them to:

Stephanie Schachter

356 Covington Road

Los Altos, CA 94024

sschachter@gmail.com