Pre Consultation Questions

To enhance your consultation experience, please fill out the form.

Name *

First

Last

Select the doctor (you can find this information in the order email) *

What is your destination(s) for the trip? *

Will you be far from civilization? *

Will you be in contact with animals? *

(Please fill out for each person in the consultation)

Do you have any chronic illnesses? *

Are you taking regular medication? *

Are you traveling with children? If yes, what are the ages of the children? *

Thank you for your cooperation.

Have a great consultation!