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Midtown Apothecary Travel Consultation
*Please add mypharmacist@midtownapothecary.com to the email section below*
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Email
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Your Full Name
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Address
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Phone Number
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Your Email Address
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Allergies
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Are you immunocomprimised? If yes, please explain; medication, health condition, chemotherapy, other?
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Are you pregnant or breastfeeding?
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Indicate All Countries and Regions and Dates of Travel, or forward your itinerary email to mypharmacist@midtownapothecary.com
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Type of Trip
Pleasure / holiday
Visiting Friend / Family
Volunteer Work
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What will your accommodations be?
Hotel, Resort, Cruise
Hostel
AirBnB or Apartment
Friends / Family
Camping
Other
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Possible Activities
Wilderness Activities / Hiking
Caving
Contact with Animals
High Altitude Activities / Climbing
Safari
Water Activites
Healthcare Activities
Eating Street Food
Is there anything else that we should know to help tailor your travel consultation?
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How did you hear about us?
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