Medical Information and Emergency Contact Form

All information provided on this form is confidential and will be viewed only by Compass staff and designated trip leaders from your academic institution. 

Please complete this form in full. The more information you choose to share, the better we are able to support and care for you throughout the program. While you are not required to disclose medical conditions or medications to Compass, choosing not to do so acknowledges that Compass may not be able to properly assist you in the event of a medical emergency or make any accommodations pertinent to any undisclosed medical conditions.

Failure to disclose pertinent medical information that will impact individual or group safety may result in removal from the trip.

Compass requires two emergency contacts for every participant.
Emergency contacts can not be other trip participants. 

NOTE: By signing your name electronically at the end of this form, you agree that your electronic signature is the legal equivalent of your manual signature. If the participant is under the age of 18, a parent/guardian should be the one to fill out and sign this form.

Compass Medication Policy

Compass asks that participants disclose any and all regular prescriptions, over-the-counter meds, vitamins or supplements being taken while on the program on this medical form.

Please store your medication in the original container with a pharmacy label identifying name, drug, dosage (be specific), time medication should be given and physician’s name. If not stored in the original container (i.e. in a pill distributor or planner), participants are asked to carry a copy of the prescription.

All participants aged 18 and older will carry and self-administer their medications. A program leader will carry and administer all medications for any participants aged 17 and younger.

All participants are requested to inform Compass of any pertinent changes (injuries, medications, allergies etc.) to their medical information that happen between the time the form was submitted and the start of the trip. This will allow our staff to support and accommodate you as needed.