MEDICAL FORMS

These instructions apply to our after school programs, summer camps, and any other programs where there won't be a teacher, parent, guardian, or scout leader present for the entire program.

Other than a photo of your child's face, no medical forms are required unless your child has a medical condition. You provided a complete medical history when you registered your child for the program, and we are able to access your child's immunization records through the Colorado Immunization Information System. 

If your child has a medical condition, when possible, we encourage you to administer medication to your child before or after the program instead of sending medication along to the program. If this is not possible and the medication must come along to the program, please follow the instructions below to: (1) submit all required forms at least two weeks before the first day of the program; and (2) arrive 30 minutes early on the first day of the program to complete medication drop off procedures. Please note that your child's counselor must carry your child's medication during the program; our Child Care Health Consultant does NOT allow students to self-carry medication. Thank you in advance for submitting your medical forms as early as possible, and planning ahead to make sure medication drop-off will go smoothly. We have many licensing requirements to check for each child, and rushing through this process compromises child safety, jeopardizes our child care license, and puts excess strain on our hard-working staff. 

Please contact Ben Jacques, Summer Camp Director (ben@blufflake.org) with any questions.

Required Forms for Medications

PLEASE make sure that the brand and dosage that your health care provider writes on your child’s form(s) EXACTLY matches the medication you will be bringing in (generic versions are okay). It is an extremely good idea to check the form over (and compare it to the medication you have) before sending the form along to us. Doctors occasionally make mistakes just like anyone else, and it is also common for providers to change the medication type or dosage slightly from year to year (e.g., Zyrtec instead of Benadryl, or 0.3 mg epinephrine instead of 0.15 mg). If your child's medication bottle says one thing, but their Medication Orders/Permission Form says something different, we legally CANNOT accept the medication (even if it's a current and valid prescription). We do NOT require a School Nurse/ CCHC signature, but you DO need to make sure there are signatures from within the past calendar year from both you and the prescribing provider.

Please use the list below to find the form(s) you need, then email all completed forms to ben@blufflake.org. If you do not submit these forms at least two weeks before the program, you risk the possibility that we will not be able to accept your child's medication and/or they will not be allowed to attend. No refunds will be issued for program days missed due to late forms.

  • Asthma Care Plan & Medication Orders - If your child has asthma and/or will be bringing an inhaler

  • Allergy & Anaphylaxis Emergency Care Plan & Medication Orders - If your child has a potentially life-threatening allergy, and/or will be bringing an epinephrine injector or antihistamine (including over-the-counter antihistamines)

  • Medication Administration Permission Form - If your child may need any other medication during the day, including any medicated ointments (e.g., Neosporin) 

  • Refusal to Provide Medication Form - If any of the following are true: (a) you will not be bringing an over-the-counter antihistamine or second epinephrine injector as ordered by the provider on your Medication Orders form; (b) your child has asthma or allergies and you are not bringing any medication; or (c) we cannot accept your medication on the first day of the program because your forms were late or you deviated from the medication drop-off procedure (see below).

Procedure to Drop Off Medication

All medication drop-offs will take place 30 minutes early on the first day of the program. For summer campers, this means 8:30am on Monday of each week. First days are extremely busy for everyone, so if you do not arrive 30 minutes early, you may be asked to wait until all other campers are checked in before we have time to check in your medication.

Please plan to spend about 5-10 minutes talking with the staff member who accepts the medication. Our staff MUST complete this Medication Drop Off Checklist before they can accept your child's medication. Please read it to know exactly what we will be looking for, and contact us ahead of time if you have any questions. Here is a summary of the most common drop-off issues, by medication type:

Common Mistakes to Avoid

  • Epinephrine: Please check the expiration date!

  • Antihistamines: We cannot swap out one kind for another! Please make sure that you buy the exact kind that your doctor wrote in on the Medication Orders/ Medication Permission form you gave us (generic versions are okay). Pay attention to whether it's supposed to be liquid (mL dose) or capsules (mg dose). Remember to check the expiration date if it's not a new bottle.

  • Inhalers: Please include a spacer! Make sure the type of inhaler exactly matches what your doctor wrote in on the Medication Orders/ Medication Permission form you gave us (generic versions are okay). Please check the expiration date. 

All of the checklist requirements must be met, or we CANNOT accept the medication on the first day of the program. We are both legally and ethically required to return the medication to you immediately. If that occurs, your options will be to either: (a) bring your child home with you and return to the program when you have all the required elements; or (b) sign a Refusal to Provide Medication Form and allow your child to stay at the program without medication, at your own risk. If there is an emergency, we will call 911 and then the parent/guardian. No refunds will be issued for program days missed due to parent/guardian deviation from medication drop-off procedures.

For summer camp programs, counselors will keep the medication(s) secure throughout the week, and return them to you at the end of the day on Friday. If your camper will be coming for two consecutive weeks, we are happy to keep medication(s) over the weekend and return them after the second week.