Annual Health and Medical Record
(Valid for 12 calendar months)
The Boy Scouts of America recommends that all youth and adult members have annual medical evaluations
by a certified and licensed health-care provider. In an effort to provide better care to those who may become
ill or injured and to provide youth members and adult leaders a better understanding of their own physical
capabilities, the Boy Scouts of America has established minimum standards for providing medical information
prior to participating in various activities. Those standards are offered below in one three-part medical form.
Note that unit leaders must always protect the privacy of unit participants by protecting their medical information.
Parts A and C are to be completed annually by all BSA unit members. Both parts are required for all events
that do not exceed 72 consecutive hours, where the level of activity is similar to that normally expended at home
or at school, such as day camp, day hikes, swimming parties, or an overnight camp, and where medical care is
readily available. Medical information required includes a current health history and list of medications. Part C
also includes the parental informed consent and hold harmless/release agreement (with an area for notarization if
required by your state) as well as a talent release statement. Adult unit leaders should review participants’ health
histories and become knowledgeable about the medical needs of the youth members in their unit. This form is to
be filled out by participants and parents or guardians and kept on file for easy reference.
Part B is required with parts A and C for any event that exceeds 72 consecutive hours, or when the
nature of the activity is strenuous and demanding, such as a high-adventure trek. Service projects or
work weekends may also fit this description. It is to be completed and signed by a certified and licensed
health-care provider—physician (MD, DO), nurse practitioner, or physician’s assistant as appropriate for y