2017 Spain Trip MEDICAL PROFILE FORM
Please answer each question fully and to the best of your ability. This data will remain COMPLETELY CONFIDENTIAL with Mr. Taylor and/or your child's chaperone.
Email address *
Traveler First Name *
Your answer
Traveler Middle Name
Your answer
Traveler Last Name *
Your answer
Emergency Contact Name *
This should match the name that was given to EF Tours online.
Your answer
Special Needs *
Does your child / do you require any special accommodations on tour (wheelchair, interpreter, etc.)?
Your answer
Allergies *
Is the traveler allergic to any medication, food, etc.? What should be done in case of a reaction? (EpiPen, etc.) EF recognizes that some travelers may have severe allergies. We will do our best to ensure that tour suppliers are informed of the situation, but we cannot guarantee that all requests are accommodated.
Your answer
Medical conditions *
Does your child / do you suffer from any pre-existing medical conditions (seizures, diabetes, mental health issues, eating disorders, etc.?) What are the warning signs that the Group Leader should be aware of, and what should be done in case of an emergency?
Your answer
Is the traveler covered by a Health Insurance Plan? *
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