CONFIDENTAL MEDICAL FORM
The information you provide to VOPO in this form will be held in the strictest confidence, and will be used only to the extent necessary to provide necessary emergency medical care and/or evaluate fitness for travel.
Who should complete this form?
All Expedition and Inhabit Project participants must complete sections ‘A’, “B”, and “C”’. If you have indicated that you have a pre-existing medical condition you are required to complete section ‘D’ also. The more information VOPO has, the more we may assist in the unlikely event of an emergency or provide other medical assistance. Please note VOPO will assess the information contained in this form, and reserve the right to ask for a physician assessment for any participants.
Why do I need to complete this form?
Our expeditions take you to remote areas where limited or no sophisticated medical facilities exist. A medical emergency situation is unlikely; however, should it arise we are armed with the necessary information to help you. You must provide complete, accurate, and up-to-date information on this form in order to allow VOPO Expeditions to safely accommodate you.
If there are any changes to your physical/medical condition or otherwise to your responses below after your submission of the form to VOPO, you must notify VOPO immediately of that change.
How do I complete this form?
It is very important for your own health and safety that you complete all questions fully and truthfully. In the event of a medical emergency, the information you have provided could be crucial. All participants must complete, and return sections ‘A’, ‘B’, ‘C’ If participants answer yes to any question in section ‘B’, then proceed to section ‘D’. Part 1 of section ‘D’ must be completed by yourself, and Part 2 given to your medical practitioner to complete on your behalf.