Outreach
Required Medical Forms
In order to provide for the health and well-being of each participant during our summer camps, we ask that parents provide medical information and a recent copy of their prescription/medical insurance card to our office.
In the unlikely event of an accident or visit to the hospital, this information will aid us in expediting medical care.
Please read, sign, and return the following notice and permission forms prior to the program start date. Please Note: If you need any forms in an alternate format, or need assistance, please contact our office at (309) 298-1911.
Please read, sign, and return the following notice and permission forms prior to the program start date.
Please Note: If you need any forms in an alternate format, or need assistance, please contact our office at (309) 298-1911.
MDH Authorization to Treat a Minor (PDF)
MDH Privacy Practice Information (PDF)
MDH Privacy Practice Form (PDF)
Beu Privacy Practices Information & Form (PDF)

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