The information you provide to Spanish 2Go School 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. Please note that this may include transmitting your data overseas to any countries to which you may be visiting, but only as required. The collection, use, and disclosure of your personal information is governed by Spanish 2Go School Privacy Policy.

Who should complete this form?

All travelers 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 Spanish 2Go School has, the more we may assist in the unlikely event of an emergency or provide other medical assistance. Please note Spanish 2Go School will assess the information contained in this form, and reserve the right to ask for a physician assessment for any passenger. Please ensure that you have confirmed with a medical professional that you are medically fit to embark on the travel you have booked.

Why do I need to complete this form?

Our immersion trip travels to a remote area where no sophisticated medical facilities exist. A medical emergency situation is extremely unlikely; however, should it arise we are armed with the necessary information to help you. If there are any changes to your physical/medical condition or otherwise to your responses below after your submission of the form to Spanish 2Go School, you must notify Spanish 2Go School immediately of that change. Spanish 2Go School reserves the right to request an up-to-date certification from a licensed physician in the event of such a change. If the information contained on this form is found to not be accurate as of your date of travel and you have not provided Spanish 2Go School with notice of such change, you may be removed from the tour with no refund or compensation payable.

What happens if I don’t complete this form?

In the event you have made a booking with Spanish 2Go School and subsequently are unable or refuse to complete this medical form for any reason by the final payment date as specified in our terms and conditions, Spanish 2Go School reserves the right to consider your booking cancelled as of that day and applicable cancellation penalties will apply.

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 passengers must complete sections ‘A’, ‘B’, ‘C’ If passengers 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. Each of you must then sign and return the entire document, sections ‘A’, ‘B’, ‘C’ & ‘D’.

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Step 1 of 2

SECTION A – GENERAL INFORMATION – Please complete all fields

SECTION B – MEDICAL INFORMATION – Please complete all fields

2. Have you ever had any of the following:

Please Note:
* If you indicated “YES” to any of the above questions (excluding question 5), you must now proceed to section ‘D’.