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Medical Questionnarie
Questionnarie
Question Yes No Comments
Infectious diseases
Other illnesses
Serious past accidents or operations
Authorization to arrange vaccinations and immunisations
Recurring disease
Required medication
Chronic Nervous Habit
Headaches
Dental plate or brace
Glasses or contacts
Special Diet
Participation in all sport
Allergies
Learning Disabilities
Allergy 1
Allergy 2
Allergy 3