Mission trips can be extremely strenuous and stressful. They may include long plane, train or bus rides of 10 to 20 hours in duration. Travelers are required to carry their own luggage. Restrooms are not always readily accessible. There can be a considerable amount of walking between lodging and activity locations, in addition to the possibility of climbing stairs. Some mission experiences require long hours of demanding work with limited time to rest. Sleeping arrangements may not be comfortable and, in most instances, you will share a room with one or more persons. Climate can be extremely hot affect your overall strength and energy. Air quality may be poor in some locations. Mealtimes are not always consistent and the ability to meet specific dietary needs is often restricted. Access to emergency medical care is very limited.
Immunizations and malaria prevention are not required but it is strongly recommended that travelers seek advice about these options from your physician or the CDC website: www.cdc.gov
Please fill out this form completely and in detail. It is very important for your safety and the success of the mission trip that the information you provide is up to date, honest and accurate. Any questions or concerns you have about this form or your medical appropriateness for the mission experience can be directed to firstname.lastname@example.org.
Failure to disclose preexisting medical conditions that present complications during your mission trip may result in sending you home at your expense. Pre-existing conditions also have limited coverage under international health insurance policies; you may be financially responsible for any medical treatment for preexisting conditions.
If you have any unstable or complicated medical/psychiatric conditions, limited physical conditioning and endurance, are significantly overweight or have very specific dietary needs, national or international mission experiences may not be appropriate for you.
Please note: If you have any serious allergies you are responsible for bringing with you an Epipen and any medications required to manage allergic reactions on an emergency basis. An emergency action plan created by you and your doctor should be provided to the trip leader.
Sleep Disorders - Electricity may not be available for C-PAP machines.
Diabetes - All diabetics should have adequate insulin supplies and equipment, glucose tablets and appropriate snacks for management of hyper/hypoglycemia while traveling. Refrigeration for medications may not be available.
If I am not feeling well at any point on this trip, I will notify the trip leader immediately. I give permission to representatives of the Haiti Deaf Academy to seek medical attention on my behalf as needed. I understand the risks associated with this trip and answer all questions to the best of my ability.