Health Forms

Physical Exam/Immunization Record Requirements

Each year all campers (including returning campers) must provide a copy of a doctor’s physical/immunization report before attending camp. For children age 5, the physical exam must have been within the past 12 months. For all other ages, a copy of the most recent report is sufficient. We accept the Virginia form, or parents may complete and attach page 1 of the Virginia form to a doctor’s, school, or state form. Forms are due by June 1.

Click here to print the Virginia School Entrance Health Form.

Medication Form

If your child requires medication during the camp day, please complete the Medication Form and give it to the camp nurse along with the medication. Do not send medication to camp with your child. The nurse begins accepting medication during the week of June 17th. Medication must be given to the camp nurse in the original packaging with the child’s name and the prescriber’s instructions. Please arrange to pick up unused medication from the nurse as we do not send unused medication home with campers.

Click here to print the Medication Authorization Form.

Forms may be emailed to summer@potomacschool.org, faxed to 703-356-3945, or mailed to Summer@Potomac, 1301 Potomac School Rd., McLean, VA 22101.