Get Girl Amp Adult Health History Record - Gscm - Gscm

The GIRL Amp ADULT HEALTH HISTORY RECORD is an essential document designed for both girl participants and adult members within the Girl Scouts of Central Maryland. This guide aims to provide clear and supportive instructions on how to accurately fill out this health history record online.

Follow the steps to complete the health history record effectively.

1. Click ‘Get Form’ button to access the form and open it in your preferred editing tool.
2. In the first section, enter the participant's name, date of birth, and address. Ensure that all details are accurate.
3. Identify the parent or guardian by filling in their name, relationship to the participant, and contact details, including phone numbers.
4. Provide information about emergency contacts, including names, relationship, and phone numbers.
5. List the name of the family physician and their contact information, as well as any medical or hospital insurance carrier details.
6. In Part I, check the boxes next to any chronic or recurring illnesses that apply. Provide dates where necessary.
7. Complete the additional health history questions concerning recent illnesses, injuries, treatments, and restrictions. Be thorough with your explanations for any 'yes' answers.
8. In Part II, check any allergies that apply and specify what kind of reactions the participant may experience.
9. Proceed to Part III to check any other health conditions that apply, including emotional disturbances, vision requirements, or dietary restrictions.
10. In Part IV, fill out the immunization history, including years of primary immunizations and last booster received. Provide additional details if necessary.
11. Confirm the accuracy of the statements and provide the date along with the signature of the parent/guardian or adult member.
12. Once all sections are completed, you can save your changes, download the form, or print it for submission.

Take the next step in ensuring your health history is accurately recorded by completing this form online.