Individual Medical Disclosure and Emergency Contact Form
Please read the following introduction carefully and fill the form truthfully, it is for your own
safety and that of the rest of the team.

This form is confidential, and is only read by key members of DGFC staff.

DGFC is located at least 60 minutes away from the nearest hospital. The trip includes transporting
the victim from wherever she/he is in the forest, to the jetty in Batu Puteh by boat, and then the trip
on land on a 2-way road. This hospital is a basic one, any major issues will be referred to Sandakan’s
hospital and that is another 2 and a half hours. If the work is to be performed in a location different
than Kinabatangan, time frame to reach medical help will fluctuate more. Our aim is to so send a copy
of this form with the victim to help the doctors receiving him/her. In addition, the information
contained here helps us plan fieldwork and be prepared in case of emergencies.

Blood type is compulsory to be disclosed by the time of arrival at DGFC. In case of severe
haemorrhage, the hospital or clinic can be informed in advance of the blood type needed instead of
waiting for a test to be done. Time is of essence and may cost lives.

A list of medication currently taken is needed for the following reasons:
1) In case of an emergency where the victim is unconscious, we need to notify the doctors.
2) To advise the applicant whether the medication is regularly available in Sabah to take precautions
with the supplies. It is not always possible to purchase every medication at any time.

Allergies are the most likely case of emergency. Self-catering is not allowed at DGFC, the logistics
officer and the kitchen staff must be notified in advance of any food allergies.

A list of medical conditions is needed for the following reasons:
1) Most of the local staff has a limited knowledge of English, communication might be difficult
sometimes, especially in the case of an emergency. The staff will be notified in advance of possible
situations occurring while working with someone with a condition.
2) We encourage everyone to keep an eye on each other’s emotional wellbeing. It is difficult to foresee
the reaction towards the environment that could come after a few days or weeks at DGFC. Some
psychiatric disorders might intensify (i.e. depression, anxiety, lack of sleep, lack of appetite, isolation
from others at the centre). Psychiatric medication is not easy to purchase in Sabah, and psychological
and psychiatric help is extremely limited.
3) If you have an existing condition, in an emergency we will try to locate your specialist to assist the
doctor leading the case in Sabah. There are not many specialists in Sandakan hospital (Specialist
hospital nearest to DGFC, at least 3 hours away), and we would like to make sure the victim has all
the help possible.

Any disabilities or impairments might result in an adjustment. An adjustment is defined by us as the
unsuitability of some projects for a person to follow (i.e. climbing a limestone hill).

DGFC has the following vaccination scheme:
- Vaccination against Tetanus is COMPULSORY for all DGFC personnel carrying out regular
field work, and recommended for the rest of the staff and visitors
- Vaccination against Rabies is COMPULSORY for all DGFC personnel carrying out regular field work, and for visitors who work on mammals and birds (if mist nets are being set); it is recommended for the rest of the staff and visitors.
- Vaccination against Hepatitis A & B is COMPULSORY for all DGFC personnel who will be
handling primates, and is recommended for visitors doing this activity.
- Vaccination against Typhoid Fever is COMPULSORY for kitchen staff and recommended for
all DGFC personnel and visitors.
- Vaccination against Japanese Encephalitis is recommended for all DGFC personnel and
REGULATIONS until further notice.

While filling this form, do not constrain your answers to the spaces provided.

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