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340 Millard Burke Memorial Hwy, Goshen, VA 24439
July 7-14, 2018


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Goshen Summer Camp


Medical Information for Goshen
Welcome to May!


If your son is going to Goshen this summer, he needs a physical. If he is in high school, he can have his sports physical (for 2018-2019) and the physical for scouts at the same time. Physicals are valid for high school sports for the school year after May 1 st . Goshen physical forms (Form C) need to be current, within 1 year of the date of visit.

Along with the 2018 re-chartering forms, medical forms for 2018 are also due for all scouts.  This applies even if your son recently joined the troop and you filled out 2017 forms. Many of you already filled out the A/B and authorization for medications form for 2018. If you sent/gave me a form after January 2018, I only
need your physical. (Form C) and the NCAC Scout risk advisory form, if you did not fill it out (The new form does NOT require a physician’s signature). The forms are the same as last year's forms except for the NCAC Scout Camp Risk Advisory Form. The new form does NOT a physician’s signature.   The new form is listed as item 5 below.

1. Authorization to Monitor Medications
2. Part A (1 page)
3. Part B (2 pages)
4. Part C (physical)
5. NCAC Scout Camp Risk Advisory Form

Note that we also require a copy (front side and back side) of your health insurance card.  It is stated on the BSA scout form part B. At this time, we require that you provide items 1-3 as soon as possible.  Items 4 and 5, Part C (the physical exam) and the Scout Camp Risk Advisory Form are due prior to the Goshen summer
camp, although we will gladly accept the form whenever the physical exam is performed.  The new NCAC Scout Risk Advisory Health Form does not require a physician signature. The forms are available at the link below.


You can either send your scout’s forms electronically or bring a hard copy to the meeting.  Note that we also require health forms for any adult who attends an overnight outing.  For adults, item 1, Authorization to Monitor Medications is not required.

If you have questions feel free to contact Troop 1128 Medical Records Coordinators.
Joanne Adelberg
Roseann Alvarez
Tim Adelberg 


© 2019 Troop 1128 – Vienna, VA - Boy Scouts of America | WordPress Admin
© 2019 Troop 1128 – Vienna, VA - Boy Scouts of America
WordPress Admin