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Climbing and Medical Questionnaire

Medical Information

Do you have medical health insurance?
Yes
No
Are you under the influence of illicit drugs or alcohol?
Yes
No
Do you have any allergies or a history of anaphylaxis?
Yes
No
Do you have a history of or currently have asthma?
Yes
No
Do you have diabetes?
Yes
No
Do you have heart disease?
Yes
No
Do you have a history of seizures?
Yes
No
Do you have any issues with seeing or hearing?
Yes
No
Have you had any relevant musculoskelatal injuries or related surgeries?
Yes
No
Do you have any other medical conditions or health issues that can inhibit your full participation in activites provided by Frontier Climbing Company?
Yes
No

Climbing Experience

Do you have previous climbing experience?
Yes
No
Can you lead climb a sport route?
Yes
No
Can you lead climb a trad route?
Yes
No
Can you lead belay?
Yes
No

Climbing Equipment Needs

Do you own a climbing helmet?
Yes
No
Do you own a climbing harness?
Yes
No
Do you own climbing shoes?
Yes
No

I have read and understood all of the questions above and I have answered them truthfully.

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