Get Cj 17 Health Information Form

The CJ 17 Health Information Form is essential for ensuring that your health information is accurately recorded for any upcoming Scouting activities. This guide provides clear and supportive instructions to help you complete the form online with ease.

Follow the steps to accurately complete the CJ 17 Health Information Form online.

1. Click the ‘Get Form’ button to obtain the CJ 17 Health Information Form and open it in your online editor.
2. Begin by filling in your basic information, including your first name, middle name, last name, date of birth (in the format YYYY/MM/DD), and your home province. Make sure to specify your gender and preferred language.
3. Provide your provincial health card number if you are a Canadian resident. If you have supplemental health insurance, fill in the details of your insurer, plan number, primary plan holder, and your relationship to the plan holder.
4. Enter your emergency contact information. Include the contact person's name, phone number, relationship to you, and where they will be during the Jamboree.
5. Indicate any allergies or food requirements. Specify if you carry an epinephrine auto-injector, list your allergies, describe the method of exposure, and detail your usual treatment.
6. Outline any religious or special dietary needs, as well as specific dietary preferences, intolerances, or allergies. Ensure to provide detail on additional preferences in Appendix A if necessary.
7. List the contact information for any health professionals involved in your care, like physicians or dentists. Include their name, type, phone number, and situation details.
8. For vaccinations, indicate whether you have been immunized for various conditions, including tetanus and chickenpox. If yes, provide the year and month of your last immunization.
9. Document any medications you will be sending to camp, ensuring that they are clearly labeled, unexpired, and adequately supplied for the entire duration of the Jamboree. Note the dosage, frequency, and conditions for which they are taken.
10. Answer questions regarding any medical conditions or assistive devices you may use, and provide additional information as necessary.
11. Complete the medical emergency procedures consent section as applicable to your province, ensuring that your name and relationship to the youth, as well as the date, are included.
12. If needed, attach any additional information in Appendix A before finalizing your form. Review all entries for accuracy.
13. Once you have completed the form, you can save your changes, download a copy, print it out, or share it as needed.

Complete your CJ 17 Health Information Form online today to ensure a smooth Scouting experience.