If you have had a vaccination please send an image of your vaccination card to firstname.lastname@example.org.
If you have not had a vaccination, please complete a PCR test 48 hours before travel and only travel if the result is negative.
We strongly recommend you take out private travel insurance to cover any eventuality. Please bring your policy details with you on the holiday
Outbound Flight Details
Date Format: MM slash DD slash YYYY
24 hour clock please
Return Flight Details
Date Format: DD slash MM slash YYYY
Medical details and physical activities readiness
Has your doctor ever said you have heart trouble? If so, please specify
Do you ever feel faint or have spells of dizziness?
Has your doctor ever told you that you have back problems? If so, please specify
Are you currently taking any form of medication? If so please specify
Do you currently have a disability or a communicable disease? If so please specify
Do you have any other medical issues, (non-diet related) allergies or injuries that you should inform us about? If so, please specify
Do you have any allergies? If yes, please specify, including severity of allergy
Do you have any other special dietary requirements? If yes, please specify
How many coffees/teas do you drink per day?
How many units of alcohol do you consume per week?
Do you smoke?
Current Activity Programme
Describe your fitness level and any current forms of exercise
Aims and expectations
What are you hoping to achieve on your in:spa retreat with us?
. Please do not share anything sensitive with us if you would not want us to store it.
Please confirm that you have read, understood and answered all questions to the best of your knowledge