Medical Update Form
Please complete this form just before your child comes to camp.

Please inform us of ANY changes to your child's medical & care needs since completing the main application form. Even if there are NO changes, please fill in stating 'No Changes'.
Please do not bring your child to camp if anyone in your family is unwell prior to them attending camp. If you are unsure about this, please get in contact with the office straight away.
Camper Name
First Name Last Name
Date of birth
Day Month Year
I consent to the medical team at camp providing routine and emergency medical care to my child.
Current Medications
Medication Dose
How it it taken
When is it taken
1
2
3
4
5
6
7
8
9
10
Please do not send Dosset boxes to camp.
Please ensure your child brings ALL medications to camp.
We ask that medications are provided in their ORIGINAL packaging.
List any allergies including drug allergies:
Please tick if your child can have the following medications:
Paracetamol Ibuprofen Piriton
If applicable, what is the very latest full blood count?
Date taken Wbc
Hb
Neutrophils Platelets
1
List any current issues/changes:
Medical & care issues eg Hickman line removed, stage of treatment, changes to diet etc
Has your child had any of the following in the last 2 weeks?
Fever Cough Rash Sore throat Conjunctivitis/pink eye Vomiting Diarrhoea Coldsore Contact with chickenpox, measles, mumps or rubella
Comments:
Please state if there are any other relevant issues that you feel we would need to know
Please give details of any recent illnesses or hospital admissions
PARENT/GUARDIAN CONTACT DETAILS
Name
First Name Last Name
Relationship to child
Home Phone
Area Code Phone Number
Mobile Number
Area Code Phone Number
Work Number
Area Code Phone Number
Charity No 1075361 & SCO43191
Should be Empty:

	Medication	Dose	How it it taken	When is it taken
1
2
3
4
5
6
7
8
9
10

Medical Update Form