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Pre-Trip Medical Form

Please note : The form will not send until all the required information is filled out, so if you click on the send button and nothing happens, simply check through the boxes to see what is missing. If you do not have any information for a category simply write nil. Make sure you read through the Terms and Conditions carefully.

Pre Trip Medical Form
(e.g. medications, pollens, food, bee or wasp stings etc)
(e.g None, Omnivore, Vegetarian, LactoVege, Vegan, Gluten free, Atkins, Low fat, Dairy Free, No Nuts)
Southern Wilderness New Zealand Limited Safety Terms & Customer Declaration See our terms and conditions here
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