Health Form

To assist us in planning an appropriate, rewarding hiking experience for you, please complete this questionnaire in full.

Asterisks (*) indicate required fields

 
 
PERSONAL INFORMATION
 
 
 
 
 
 
 
 
 
 
 
 
 
Female Male
 
 
 
 
Own Vehicle Car Rental Other
 
MEDICAL INFORMATION
 
EMERGENCY CONTACT  person to notify in case of emergency
 
 
 
 
PERSONAL PHYSICIAN
 
 
 
ALLERGIES
 
 
MEDICAL
 
 
 
 
 
Yes No
 
 
 
PHYSICAL INFORMATION
 
These are physically demanding hikes. Please make sure you have read and understand the daily hiking mileage and elevation gains for the week you are hiking. We want you to have a good time!
 
 
 
Yes No
 
 
Yes No
 
Yes No
 
 
FOOD
 
Unrestricted Gluten free Lactose intolerant Kosher Vegetarian Vegan
 
 
 
NOTE: If there is any brand and/or specific food product that you need, we ask you to please bring it yourself. We try to cater to each of our clients' needs. Please let us know if there is anything that will make your trip more enjoyable. If we don't know then we cannot guarantee those items will be available.
 
MISCELLANEOUS
 
Yes No