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HEALTH HISTORY FORM AND RELEASE LOYOLA UNIVERSITY OF CHICAGO CHALLENGE COURSE PARTICIPANT PLEASE PRINT This form will be kept confidential. Its purpose is to provide Loyola s Office of Outdoor Experiential
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How to fill out challenge course health history

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How to fill out challenge course health history:

01
Start by obtaining a copy of the challenge course health history form. This can typically be found on the website or provided by the course facilitator.
02
Fill in your personal information, including your name, date of birth, and contact details. Make sure this information is accurate and up to date.
03
Provide a detailed medical history. This may include any past illnesses, injuries, surgeries, or chronic conditions you have experienced. Be thorough and include any relevant information that may impact your participation in the course.
04
List any current medications you are taking, including dosage and frequency. It is important for the course facilitator to be aware of any medications that may affect your ability to safely participate in the activities.
05
Indicate any allergies or sensitivities you have. This may include food allergies, environmental allergies, or medication allergies. If necessary, provide information on how these allergies are typically managed or addressed.
06
Answer any additional questions related to your physical health or fitness level. These questions may ask about your exercise habits, any recent changes in your health, or any restrictions on physical activity you may have.
07
Sign and date the form to indicate that the information provided is accurate and complete. If applicable, provide emergency contact information as well.
08
Return the completed form to the course facilitator or follow the instructions provided on how to submit the form.

Who needs challenge course health history:

01
Individuals who are planning to participate in a challenge course or ropes course usually need to complete a challenge course health history form.
02
This requirement is in place to ensure the safety and well-being of all participants. By providing a comprehensive health history, course facilitators can identify any potential risks or concerns and make necessary accommodations.
03
It is important for participants to be honest and transparent when filling out the form, as this information will be taken into account when determining their eligibility and level of participation on the course.
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Challenge course health history is a form that collects information about an individual's medical history to ensure they are physically able to participate in a challenge course.
Any individual who wishes to participate in a challenge course is required to file a challenge course health history form.
To fill out challenge course health history, individuals need to provide detailed information about their medical history, current health status, and any existing medical conditions or limitations.
The purpose of challenge course health history is to ensure the safety of participants by identifying any medical conditions or limitations that may impact their ability to safely complete the course.
Information such as medical history, current health status, existing medical conditions, allergies, medications, and any physical limitations must be reported on challenge course health history.
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