Medication Notice This notice is extremely important so please read it carefully and initial on each line below, follow the instructions completely and sign the consent at the bottom of this page. If you disagree with any of the statements here, please cross out that section and initial it. Explain your wishes in the comments section or attach an additional sheet if necessary. ALL Campers/Staff who bring medications to camp must meet the following REQUIREMENTS:
______ The Physician who ordered the medication (s) has completed, dated, and signed an authorization form for each medication individually . If there is more than one physician prescribing medications, then each individual physician must submit a form with the medications they prescribed listed. ______ The Physician (s) has listed all the medications the camper is bringing to camp and note if said medication (s) will be SELF ADMINISTERED. ______ALL over the counter drugs must be in the original bottle/box, labeled and have the person’s name written on it. ______The Camper/Staff knows what medications they are taking and how important it is that they report to the health lodge to take them as prescribed.
______On Registration day, bring the medications in a bag with the name of the camper/staff member on it.
______ Please bring only the number of pills that will be needed for the week (and maybe a few extra in case one drops) since the nurse must count all of the medications brought and enter them in to a log. ______ I give permission for the Camp Health Officer to administer over the counter medications for conditions as directed by the Camp Physician.(the over the counter medications may include WOUNDS: Betadine, Hydrogen Peroxide, Bacitracin antibiotic ointment, POISON IVY: Tecnu, Benadryl cream CANKER SORES: Benzocaine Cream PAIN: Tylenol, Ibuprofen, DYSMENORRHEA: Ibuprofen ABDOMINAL DISCOMFORT: Tums, Maalox HEADACHES: Tylenol, Ibuprofen HYPOGLYCMIA: Glucose gel, Glucagon ALLERGIC REACTION: Benadryl or generic, Epipen ATHLETE’S FOOT: Tinactin INSECT STING/BITE: Benadryl cream, Hydrocortisone cream, Caladryl or Calagel, Epipen TICK BITES: Alcohol or Hydrogen Peroxide 1ST DEGREEBURNS: Burn Jell, Aloe Spray EMERGENCIES: Oxygen, Generics may be substituted. Consent IMPORTANT for minors: In case of il ness or accident during the trip to and from the New Heights Summer Camp, or while at camp, and when New Heights is unable to contact us through reasonable effort, we the self/parents/guardians of _______________________________, hereby consent to the giving of any and al emergency medical care to our child named above that may be deemed necessary by an official of the Camp in consultation with any physician or hospital without obtaining further consent. I agree to the release of any records necessary for treatment, referral, bil ing or insurance purposes. Parent/guardian’s signature
The emergence of EDI (Electronic Data Interchange) in modern trade has created the need for newarrangements in trade practices which can regulate adequately the relations between the tradepartners. The replacement of the manual way of conducting trade with the electronic one gives riseto particular legal problems. When using electronic trade the upcoming legal questions can threatento destabilise
Camper Name: ____________________________________________ Date of Birth: ________________ This MUST be completed by a licensed PHYSICIAN and is REQUIRED for camper ATTENDANCE. Standing Orders: *Form must be filled out each year. Attention Physician: The following Over-the-Counter medications will be available in the Health Center. Administration of these medications is “per label directionsâ
Medication Notice