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5-Week Summer Ballet Program - Central Pennsylvania Youth Ballet

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Medical Services and Facilities<br />

Medical Form<br />

The Medical Form is to be filled out by a parent or guardian<br />

if the student is under the age of 18. It is very important that<br />

all questions be carefully completed. Please keep in mind that<br />

insufficient information may hinder medical treatment in the<br />

event of an emergency. Basic medications that your student is<br />

allowed to take, including Tylenol, Advil, Pepto-Bismol, Midol,<br />

etc. must be listed on your student’s form.<br />

Additionally, the Health History Evaluation in the<br />

registration packet must be completed and signed by a<br />

licensed Health Care Practitioner, and dated within three<br />

months of the start of the <strong>Program</strong>.<br />

Nurse<br />

CPYB has a nurse available for the duration of the <strong>Program</strong>,<br />

Monday-Friday from 6:30 p.m. to 9:30 p.m., to address any health<br />

issues that may arise. Outside of those dates and times, the nurse<br />

is available on an on-call basis at the rate of $50 per visit, which<br />

will be deducted from the emergency fee. (please see page 4 for<br />

additional information regarding the emergency fee.)<br />

Physical Therapist<br />

For normal aches and pains resulting from the rigors of ballet<br />

training, a physical therapist will be available each week. The<br />

physical therapy schedule will be published at the beginning<br />

of the <strong>Program</strong>. To minimize health risks, CPYB also provides<br />

several seminars which address topics such as diet, nutrition and<br />

injury prevention.<br />

Emergency / Hospital Visits<br />

When Carlisle Pediatric Associates is closed emergencies are seen<br />

at the Carlisle Regional Medical Center. The hospital emergency<br />

phone number is 717.960.1695, and the general information<br />

number is 717.249.1212. Any charges incurred above the<br />

emergency fee will be billed to the student’s parents/guardians at<br />

the conclusion of the <strong>Program</strong>.<br />

Please note that all hospital visits are the responsibility of the<br />

student’s family. Any visits to a dentist or orthodontist must also<br />

be paid for by the student’s insurance or must be paid for in<br />

cash at the time of the visit. If the student’s dental insurance<br />

is not from regular medical insurance, be sure that the student<br />

brings the dental insurance card. CPYB will not arrange or aid in<br />

visits to trainers, massage therapists, chiropractors, etc., without a<br />

physician’s note.<br />

Carlisle Pediatric Associates<br />

All students living on-campus will have access to Carlisle<br />

Pediatric Associates. Visits to Carlisle Pediatric Associates will<br />

be deducted from the student’s Emergency Fee (see page 4).<br />

Carlisle Pediatric Associates<br />

804 Belvedere Street<br />

Carlisle, PA 17013<br />

717.243.1973<br />

While visits to the physical therapist are free of charge, the<br />

cost of training equipment, emergency room visits, etc., will be<br />

deducted from a student’s Emergency Fee.<br />

14

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