• Dome Tours International Ltd

    Hajj Medical Screening Questionnaire

  • Emergency Contact Information

  • Medical History (Past / Current) Please tick either yes or no

  • Current Medication (Please list your current medication and attach the right side of your repeat prescription)
  • Allergies (Please list any food or drug allergies)
  • Please be advised that Dome tours cannot be responsible for any medication that may be lost, mislaid or forgotten during the course of your trip.
    I have read and fully understood the need for this information and have answered the questions as thoroughly and accurately as I am able.
    I accept full responsibility if I have not disclosed OR if I have chosen to withhold information about any medical condition.
    I acccept that Dome Tours cannot be held responsible for any information that has been withheld regarding any past or current medical condition.
    I understand that the doctor(s) accompanying the Dome Tours Hajj Group are there only in an advisory capacity but may assist in primary care in case of emergency.
    All passengers MUST be responsible for supplying their own medication and ensuring that they have sufficient quantity to cover the full duration of their stay in KSA.
    You will need at least three weeks supply or enough to cover the duration of your chosen Hajj.