Please complete this medical and health information form. Answering in the affirmative to any of the questions below will not automatically disqualify you from participating in the program.
Please be honest and forthcoming with your answers. Advanced medical care is NOT typically available during the program. JIRP will have medical personnel on hand, and all field staff will have Wilderness Advanced First Aid certification (minimum). The more complete medical information we have on hand, the more optimally we can assist in case of an emergency or medical issue.
Any divulged information will be kept private and will not be shared with any outside entity. By signing this form, you acknowledge that in the case of medical issue or need for treatment, this medical/health information may be shared with attending JIRP personnel and/or appropriate medical personnel.
Medical and Health History Form
Juneau Icefield Research Program
Juneau Icefield Research Program | , Juneau, Alaska