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Blue Ridge Mountains
Scout Reservation
Unit #: _______ Council: __________________________________ Date Attending Camp: _______________ Camper’s Name: ____________________________________________________________________________ Name of Parent or Guardian: ______________________________________ Phone: (____) _______________ Doctor’s Name: _________________________________________________ Phone: (____) _______________ Medication / Strength: _____________________________________________________________ Reason for medication: _____________________________________________________________ When was medication started? ________________________ Temporary: _____ Permanent: _____ Side effects (reactions to food, dehydration, stress, iodine, other medications, decreased balance,motor activity, concentration, drowsiness, lethargy, etc.): __________________________________ Special storage instructions: _________________________________________________________ Medication / Strength: _____________________________________________________________ Reason for medication: _____________________________________________________________ When was medication started? ________________________ Temporary: _____ Permanent: _____ Side effects (reactions to food, dehydration, stress, iodine, other medications, decreased balance,motor activity, concentration, drowsiness, lethargy, etc.): __________________________________ Special storage instructions: _________________________________________________________ Medication / Strength: _____________________________________________________________ Reason for medication: _____________________________________________________________ When was medication started? ________________________ Temporary: _____ Permanent: _____ Side effects (reactions to food, dehydration, stress, iodine, other medications, decreased balance,motor activity, concentration, drowsiness, lethargy, etc.): __________________________________ Special storage instructions: _________________________________________________________ Medication / Strength: _____________________________________________________________ Reason for medication: _____________________________________________________________ When was medication started? ________________________ Temporary: _____ Permanent: _____ Side effects (reactions to food, dehydration, stress, iodine, other medications, decreased balance,motor activity, concentration, drowsiness, lethargy, etc.): __________________________________ Special storage instructions: _________________________________________________________ Blue Ridge Mountains
Scout Reservation
Prescription Medication Card
Prescription Medication Card
Breakfast Lunch Dinner Evening Other: ________ Breakfast Lunch Dinner Evening Other: ________ Name: _________________________ Unit: ______ Name: _________________________ Unit: ______ City/State: _________________________________ City/State: _________________________________ Medications: _______________________________ Medications: _______________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ Program:
Program:
Powhatan Ottari Claytor Fish Camp Mt. Man Powhatan Ottari Claytor Fish Camp Mt. Man Parent’s Signature: __________________________ Parent’s Signature: __________________________ Date: _________ Daytime Phone: _____________ Date: _________ Daytime Phone: _____________ Prescription Medication Card
Prescription Medication Card
Breakfast Lunch Dinner Evening Other: ________ Breakfast Lunch Dinner Evening Other: ________ Name: _________________________ Unit: ______ Name: _________________________ Unit: ______ City/State: _________________________________ City/State: _________________________________ Medications: _______________________________ Medications: _______________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ Program:
Program:
Powhatan Ottari Claytor Fish Camp Mt. Man Powhatan Ottari Claytor Fish Camp Mt. Man Parent’s Signature: __________________________ Parent’s Signature: __________________________ Date: _________ Daytime Phone: _____________ Date: _________ Daytime Phone: _____________ Blue Ridge Mountains
Scout Reservation
AS NEEDED MEDICATION
AS NEEDED MEDICATION
(for example: Claritin, Tylenol, sinus medication) (for example: Claritin, Tylenol, sinus medication) Name: __________________________ Unit: _______ Name: __________________________ Unit: _______ City/State: ___________________________________ City/State: ___________________________________ Medication: ________________________________ Medication: ________________________________ Proper dosage is: ____________ every: ________ Proper dosage is: ____________ every: ________ Distribute as needed for: ______________________ Distribute as needed for: ______________________ __________________________________________ __________________________________________ Medication: ________________________________ Medication: ________________________________ Proper dosage is: ____________ every: ________ Proper dosage is: ____________ every: ________ Distribute as needed for: ______________________ Distribute as needed for: ______________________ __________________________________________ __________________________________________ PROGRAM: Powhatan Ottari Claytor Fish Camp
PROGRAM: Powhatan Ottari Claytor Fish Camp
Mt. Man High Knoll Voyageur New River Adventure Mt. Man High Knoll Voyageur New River Adventure Parent’s Signature: ___________________________ Parent’s Signature: ___________________________ Date: _________ Daytime Phone: ______________ Date: _________ Daytime Phone: ______________ AS NEEDED MEDICATION
AS NEEDED MEDICATION
(for example: Claritin, Tylenol, sinus medication) (for example: Claritin, Tylenol, sinus medication) Name: __________________________ Unit: _______ Name: __________________________ Unit: _______ City/State: ___________________________________ City/State: ___________________________________ Medication: ________________________________ Medication: ________________________________ Proper dosage is: ____________ every: ________ Proper dosage is: ____________ every: ________ Distribute as needed for: ______________________ Distribute as needed for: ______________________ __________________________________________ __________________________________________ Medication: ________________________________ Medication: ________________________________ Proper dosage is: ____________ every: ________ Proper dosage is: ____________ every: ________ Distribute as needed for: ______________________ Distribute as needed for: ______________________ __________________________________________ __________________________________________ PROGRAM: Powhatan Ottari Claytor Fish Camp
PROGRAM: Powhatan Ottari Claytor Fish Camp
Mt. Man High Knoll Voyageur New River Adventure Mt. Man High Knoll Voyageur New River Adventure Parent’s Signature: ___________________________ Parent’s Signature: ___________________________ Date: _________ Daytime Phone: ______________ Date: _________ Daytime Phone: ______________

Source: http://www.troop221bsa.org/assets/camp-med_forms.pdf

medicaldental.org

GENERAL INSTRUCTIONS FOR PREPARATION OF MEDICATION FOR PHARMACY NOTE: Please be aware that all information contained in this pharmacy manual is subject to change based on availability, cost, laws of Honduras, and policy changes of the Honduras Baptist Dental Mission, Inc. 1. Order as many drugs as possible from the following: MAP International International Medical Resources P.O. Box 2

D:\wpdocs\226\226_lab_manual\226_expt06_pro.w10

Caffeine is a member of the class of compoundsorganic chemists call alkaloids . Alkaloids are nitrogen-containing basic compounds that are found in plants. Theyusually taste bitter and often are physiologically active inhumans. The names of some of these compounds arefamiliar to you even if the structures aren’t: nicotine,morphine, strychnine, and cocaine. The role or roles thesecompound

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