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Outdoor Adventures Participant Medical Form
Please fill out this medical form in preparation for your upcoming trip with UCLA Recreation Outdoor Adventures. This form will be reviewed by the OA Supervisor, Liz Bernier, and your guides to help plan and prepare our trip to best assist you in case of a medical emergency. This information may also be shared with medical professionals, in the event that you are taken to further medical care. If you have any concerns about possible medical problems, we encourage you email Liz in advance. Many of your guides are certified Wilderness First Responders, which means that they are cautious and trained to assist you with medical emergencies in the backcountry. Outdoor Adventures aims to provide both safe and accessible wilderness experiences. We will do all that we are able to accommodate your needs while providing a safe trip for you and the group as a whole. Your timely and thorough submission of this form is essential to our preparations.

Should any of your health information or needs change between the time of submission of this form and your trip's departure, it is your responsibility to notify the OA Program Director, Liz Bernier.

[ebernier@recreation.ucla.edu]

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