Road scholar health forms 2026

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  1. Click ‘Get Form’ to open the Road Scholar Health & Safety Form in the editor.
  2. Begin by filling in your Program # and Date at the top of the form, followed by your legal name and nickname for the name tag.
  3. Provide your home address, phone numbers, age, and birthday. Indicate your gender and smoking status by checking the appropriate boxes.
  4. List any traveling companions or roommates, along with an emergency contact's name and relationship. Include their phone numbers for easy access.
  5. In the medical information section, answer questions regarding any medical conditions or restrictions that may affect your participation. Be specific if you answer 'Yes.'
  6. Indicate if you require any mobility aids or medications regularly. If applicable, provide details about food allergies and insurance coverage.
  7. Review all entries for accuracy before signing at the bottom of the form. Ensure you return it to the designated Program Provider at least three weeks prior to your program start date.

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