Client questionnaire

Client questionnaire

If you’re booked in with us for an activity then please fill this confidential form in so we’re aware of any specific needs you might have from a fitness or medical perspective. If there’s anything we feel we need to chat about prior to your booking then we’ll be in touch.

Please enable JavaScript in your browser to complete this form.
Name
If you don't have a mobile phone then please supply a land line number if possible.
Your age
Walking fitness level
Please give an honest estimate of how fit you think you are in regard to general hill walking. This will help us pace your activity and get the best from your day.
Medical condition(s) information
If you have ticked answer 2 and/or 3 then please enter details below.
Please list any medications you take to manage the aforementioned condition(s).
Allergies?
If the answer is yes, please give us details of any allergy or allergies below.
Allergy antidote(s) carried? (ie EpiPen, inhaler etc.)
Please tell us of the specific antidote you carry and how it should be administered.
Next of kin name
Should we need to contact your next of kin we need their details.
Next of kin's relationship to you
Is there any other information you feel we should know about you?