Outdoor Lab Medical Form- JVA
All 6th grade students and high school leaders must have a medical form submitted by a parent/guardian in order to attend Outdoor Lab.
Sign in to Google to save your progress. Learn more
Email *
STUDENT'S first name *
STUDENT'S last name *
STUDENT'S birth date *
MM
/
DD
/
YYYY
Parent/Guardian first and last name & Phone # *
The following over-the-counter medications are available at both Mt Evans and Windy Peak and may be administered by the Outdoor Lab clinic staff when indicated. Check each medication that you give permission for the Outdoor Lab staff to administer.
Aloe Vera
Acetaminophen (tylenol)
Benadryl
Benadryl Cream
Cough Drops/ Throat lozenges
Chlor- Trimeton
Gatorade
Hydrocortisone Cream 1%
Hydrogen Peroxide (1/2 strength)
Okay to give
The following over-the-counter medications are available at both Mt Evans and Windy Peak and may be administered by the Outdoor Lab clinic staff when indicated. Check each medication that you give permission for the Outdoor Lab staff to administer. Part 2    
Imodium
Ibuprofen
Milk of Magnesia
Neosporin/ Antibiotic ointment
Robitussin DM (cough Syrup)
Sudafed PE (age 12 & up only)
Sun- Screen
Tums
Okay to give
Does your student have any health conditions/concerns or a recent injury/hospitalization? If yes, please LIST ALL below. *
What medications, supplements, medical devices, or emergency medications (i.e. inhalers, EpiPens, etc.)  are you sending to Outdoor Lab? LIST ALL. *
If you are sending medications to Outdoor Lab please follow the link below for the required medication form. This form will need to accompany the medication(s) you have prepared/packaged for the trip. Provide completed form and medication(s) to the Health Room at your home school. The form can also be found on the Outdoor Lab Website in case you need to access at a later time.                                          
https://drive.google.com/file/d/1K7slnn1XVLxM0EiYsIPwZc-l2EKUWvex/view?usp=sharing   

Or at https://outdoorlab.jeffcopublicschools.org/   Under the 2021-2022 Information Tab
I certify that I have followed the above link and will send the printed/signed form with any medications that I am sending to Outdoor Lab. *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Jefferson County Public Schools. Report Abuse
Google Forms