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Health Survey Form docx 2026

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The document is a health survey form for the Town of Babylon Day Camp, requiring parents or guardians to provide essential health information about their child, including any special care needs, allergies, regular medications, and physician contact details. It emphasizes the necessity of submitting updated immunization records and completing the form by the first day of camp.

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Click ‘Get Form’ to open the Health Survey Form in the editor.
Begin by entering the camper’s name and date at the top of the form. Ensure accuracy as this information is crucial for identification.
In the first section, answer whether there are any health concerns that the camp should be aware of. If yes, provide detailed explanations in the space provided.
Next, indicate if your child has any allergies. If applicable, specify these allergies and confirm if an EPI pen will be brought to camp.
Proceed to state whether your child takes any medication regularly. If so, list all medications along with their corresponding conditions.
Indicate if medications will be needed during camp hours and remember to fill out a separate medication form if necessary.
Finally, provide your child's physician's name and telephone number, then sign as a parent/guardian at the bottom of the form.

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2011	4.7 Satisfied (40 Votes)

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Health Survey Form docx 2026

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