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Microsoft word - 2012 medications at camp.doc

Over the Counter Medications - 2012
I hereby give permission for Camp Nor'wester to administer specific over-the-counter medications, or their generic equivalent, to my child if the nurse/nurse practitioner deems it necessary. Dosages will be administered according to directions on the bottle unless a physician directs otherwise. The over-the-counter medications listed below will be stored in the Health Center. The camp nurse will dispense these medications. All medications will be given based on symptoms and appropriate dosages as stated on all medication packaging. Allergies and contraindications will be checked for every person before administering non-prescription medications. Cross out any medications listed above that your child should not receive.
Session: __________________________ Unit: __________________ Date: _________________ Parent signature ____________________________________________________________________ Name of camper: ____________________________________________________________________ All pill-form medications sent to camp (prescribed and over the counter) must be repackaged by a
pharmacist into a ‘bubble-pack’, clearly marked with your child’s name, the medication and the dosage to be administered. This eliminates double handing of medications and will ensure accurate and timely distribution. Local, independent pharmacists will likely provide this service, either free of charge or for a fee. Larger, chain store pharmacies will be less likely to provide this service. Your physician may also be able to provide some assistance. There will be a $30.00 charge for any medication that has to be packaged at camp. Any medications that cannot be bubble-packed (inhalers) must come in the original packaging/bottle that
identifies the name of the medication/ supplement, the dosage, and the frequency of administration. The container for a prescription must have the original label containing the name of the prescribing physician, the patient’s name, date, and dosage instructions. If possible, please send enough medication to last for the duration of your camper’s stay at camp. If a medication is non-essential (multi-vitamins/fluoride, etc) we ask that you seriously consider not sending the medication at all. If these medications are sent to camp they need to be repackaged as requested above. If your child suffers from environmental allergies we consider Claritin-type medication essential and encourage you to send a supply with your camper.
IMPORTANT NOTE:
On the day that your child comes to camp, please put all medications into a plastic
Zip-loc type bag labeled with your child’s name. DO NOT PACK MEDICATION IN TRUNK. Have your child put this
package in his/her daypack. The child’s counselor will collect these packets just before the campers get onto the charter
boats and will give them to the nurse upon arrival at the camp.
Check one:
_____ This person takes NO medications/supplements on a routine basis.
_____ This person regularly takes medications/supplements as follows: (Attach additional pages if necessary)
Medication/Supplement ________________________________ Dosage ______________________
Specific times taken each day __________________________________________________________
Length of time child has been on this medication/dosage _____________________________________
Reason for taking ____________________________________________________________________
Medication/Supplement ________________________________ Dosage ______________________
Specific times taken each day __________________________________________________________
Length of time child has been on this medication/dosage _____________________________________
Reason fo taking ____________________________________________________________________
Medication/Supplement ________________________________ Dosage ______________________
Specific times taken each day __________________________________________________________
Length of time child has been on this medication/dosage _____________________________________
Reason for taking ____________________________________________________________________
Medication/Supplement ________________________________ Dosage ______________________
Specific times taken each day __________________________________________________________
Length of time child has been on this medication/dosage _____________________________________
Reason for taking ____________________________________________________________________
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Source: http://norwester.org/Documents/2012MedicationsatCamp.pdf

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