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Medical Information Form

THIS FORM IS DUE BY June 9, 2024.

All fields with a green * are required.

It is recommended that you submit the form via computer or tablet. Some are having difficulties using a smart phone.

  • Please complete the table with any drug, food, or environmental allergies. If there is not enough room, please provide additional information in the box below the table..

  • Please check any of the following that apply. Please select "None of these" if none apply.

  • Please use the space below to explain any item checked above or any other health-related issue that would enable us to better care for your child.

  • Medication is any substance a person takes to maintain and/or improve health. This includes vitamins and natural remedies. Camp Areté requires original pharmacy containers with labels showing the patient’s name and how the medication should be given. MEDICATIONS MUST BE ORIGINAL, LABELED CONTAINERS. DO NOT SEND MEDICATIONS IN DAILY PILL DISPENSERS. Please provide enough medication to last the entire time the camper will be at camp. All medication will be collected by the camp nurse and dispensed according to the prescription label. Please complete the chart below indicating the medication your child will need to take in camp. Any medication not listed below will not be administered in camp and will be confiscated by the nurse. Please contact camp staff for further instructions if medication is prescribed and sent to camp after these forms have been submitted.

  • Please use the space below to add any additional medication/dosage information, if needed.

  • The following over-the-counter medications may be stocked in camp and used on an as-needed basis to manage illness or injury. Please check any of the following medications that you DO NOT want administered to your child:

  • MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.