Please complete the form below as soon as possible after you have booked your trip.
trekMountains operate in often extreme and inhospitable terrain and most of our treks demand a fairly high degree of physical fitness and health. Please fill in this form carefully, detailing your medical history. We will treat all information in the strictest confidence and send it to the in-country agent and, if applicable, to the trek leader or medic responsible for your safety and welfare during your trek with us.
If you have a history of any of the following medical conditions, please give details such as frequency, severity and aggravating factors where necessary. If you have had an operation within the last year, whether minor or not we need to know the details of the operation and the outcomes and possible long term problems, particularly ones that may occur or be accentuated if strenuous and physically demanding exercise is taken.
It is the responsibility of each trekker to ensure that he/she is adequately insured for the trek, including activities undertaken, and the altitude. Helicopter rescue and repatriation must be a part of the insurance policy. Pre-existing medical conditions must be declared to the insurance company.
If you prefer to submit this form by printing it off, scanning or photographing it and emailing it back to us, there is a printed version here.