Ultra Skyrunning Madeira 2019 Questionário Médico / Medical Questionnaire
Os dados deste formulário são confidenciais e apenas serão partilhados com a equipa médica responsável pela segurança do evento USM. / The data resulting from this questionnaire is confidential and will only be shared with the medical team that will assist athletes on the race day.
Email address *
IDENTIFICAÇÃO /IDENTIFICATION
Nome/ Name: *
Your answer
N.º Identificação (BI/CC/Passaporte) / Identification Card number/ Passport *
Your answer
Prova / Race *
Required
Idioma / Language: *
Realizou exame médico desportivo nos últimos 12 meses? / Have you been submited to sports medical examination in the past 12 months? *
Required
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