MEDICAL INFORMATION FORM.

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Do you have any Regular Vaccine?
Yes
No

Regular Vaccine

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Do you have another type of vaccine?
Yes
No

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Do you have any Travel Vaccine?
Yes
No

Travel Vaccine

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Do you have another type of vaccine?
Yes
No

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Do you have any Travel Medicine?
Yes
No

Travel Medicine

PRESCRIPTION MEDICATIONS IN CONTINIOUS USE

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PRESCRIPTION MEDICATION IN USE OCCASIONALLY

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Do you have any Travel Certificates?
Yes
No

Travel Certificate

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