• Trip Medical Form

  • Personal Information

  • Gender*
  • Date of birth*
     - -
  • Format: (000) 000-0000.

  • Passport Information

  • Date of issue*
     - -
  • Date of expiry*
     - -

  • Emergency Contact Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Medical Information

  • Your Consent for Emergency Medical Care:

    You agree to allow the provision of emergency medical care in the event of injury or illness during the trip. Our leadership team is equipped with a comprehensive medical kit to effectively and efficiently address any issues that may arise. Additionally, we have the support of International SOS, a provider of 24-hour medical and security assistance.

    Medical Support during the Trip:

    We offer medical support in the following ways:

    First Aid: Participants will be accompanied by staff members with First Aid qualifications, and they will manage first aid within the team. Over-the-counter medications may be administered as directed on the packaging.

    Advanced First Aid: Each trip includes a staff member with an Advanced Medicine Qualification who can address medical cases according to guidance from International SOS Medical Professionals.

    Professional Medical Care: In the event of a major incident, we seek support from local emergency services. For serious but non-urgent incidents, we rely on International SOS authorized hospitals or facilities for professional medical care.

    Medical Policies and Data :Our medical policies, procedures, and advice are developed from a UK medical perspective by our external medical advisor and shared with our Medical and Security Assistance providers, International SOS.

    Health-Related Personal Data :We collect medical information about participants to ensure trip suitability, proper management of illnesses, and the safety of all attendees. Dietary and medical information is shared with partner organizations to plan catering and assist in incident prevention and management.

    We process health information based on explicit consent provided on behalf of the participant. You (or the student) can withdraw this consent at any time by contacting us. However, withdrawing consent means the individual cannot attend the trip. If consent is withdrawn while the participant is on a trip, we will continue to rely on it until the trip ends.

    Participant's Medical History Questionnaire:

    Please complete the following questionnaire regarding the participant's medical history and provide additional details if necessary.

  • Have you/they ever had/suffered with the following:

     

  • Sleep Walking*
  • Diabetes*
  • Problems with lifting carrying or mobility*
  • Any recent injury or illness*
  • Blood Disorders*
  • Epilepsy/seizures or blackouts*
  • Asthma or breathing difficulties*
  • Heart/chest or lung problems*
  • Anxiety/ depression/ eating disorders or have seen a psychiatrist*
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  • Do you/they require an Epipen? If yes, please bring two.

  • Vaccinations and Other Information

  • Please ensure that the participant visits their doctor prior to the trip, to ensure they have to correct vaccinations. It is also advisable to have a dental check-up prior to departure.

    Has the participant had or will they be having, before the trip, the following vaccinations: 

  • COVID*
  • Tetanus*
  • Hepatitis A*
  • Typhoid*
  • MMR (Measles, Mumps and Rubella)*
  • Polio*
  • Diphtheria*
  • Yellow Fever*
  • Hepatitis B*
  • Rabies*
  • Cholera*
  • Do they or have they taken steroid tablets?
  • Date
     - -
  • Should be Empty:
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