Get Questionnaire Remplir Avant De Partir En Voyage

This guide provides comprehensive instructions on filling out the Questionnaire Remplir Avant De Partir En Voyage online. By carefully completing this form, you can ensure that healthcare professionals can assist you with travel health recommendations tailored to your needs.

Follow the steps to complete the travel health questionnaire effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in your personal information. This section includes fields for your first name, last name, address, postal code, date of birth, gender, phone number, email, and family doctor’s contact information.
3. Provide details about your travel plans. Indicate the purpose of your travel, whether it is for vacation or other reasons, and specify your type of accommodation. Also, mention your departure date and travel duration.
4. List the places you plan to visit. Include the countries, cities or regions, and the specific dates for each location, formatted as mm/dd/yyyy. Answer whether you will be visiting rural areas.
5. Outline your planned activities. Check all applicable options such as dining at local restaurants, engaging with animals, excursions outside your resort, or participating in extreme sports.
6. Indicate if you suffer from motion sickness by selecting yes or no.
7. Discuss your medical history. Provide information regarding chronic illnesses, current medications, allergies, and if any potential pregnancy risks apply.
8. Review your vaccination history. Confirm if your routine vaccinations are up-to-date and list any specific vaccines you have received, including dates.
9. Finalize any additional comments or questions that may arise from your responses, ensuring that you provide sufficient context for your pharmacist.
10. Once all fields are completed, review the entire form for accuracy. Save your changes, download a copy, print it out, or share it as needed for your health professional's review.

Complete your travel health questionnaire online to ensure safe and healthy travels!