health.sanadcare@gmail.com

+212 704 524 625

Sanad Care

Pre-Travel Health Questionnaire

Please complete below your arrival information. This helps us prepare your care before your arrival.

Your progress

0 of 17 completed

0%
Your Details
Health Questionnaire

Answer every question so our nurse can prepare your care safely.

Do you have an ongoing heart, kidney, or liver condition?
Are you currently pregnant or breastfeeding?
Do you have a known allergy to any medication?
Do you regularly take blood thinners or anti-inflammatory medication?
Are you currently experiencing any symptoms that concern you?
Do you have a history of dizziness or fainting?
Are you currently hospitalized or under medical treatment?
Have you had difficulty with IV access (finding a vein before)?
Is this your first IV treatment?
Consent
  • By submitting this form, I understand the information is secure and will be used only to prepare my care.
  • I confirm that I have disclosed all relevant information and that I agree to follow the nurse's instructions and safety guidance.
  • I understand that treatment or medical care may involve a physical examination and a blood draw procedure if required.

You review and send the message yourself on WhatsApp.

On the day of your visit, our nurse will check your vital signs and, if needed, ask additional questions before treatment.