4 Do you any indication of your allergies which would assist UCC or Yes No medical staff in the event of illness? If yes, please explain: 5 Are you currently taking any medications? Yes No If Yes, please explain: 6 Have you had any injuries, surgeries, diseases or ailments in the Yes No past five years? If Yes, please explain: 7 Is there any additional information (concerning medical conditions or Yes No mental, learning or physical disabilities) that would require action in the event of a medical emergency or be helpful for the programme to be aware of during your study abroad experience? If Yes, please explain: Declaration
4 Do you any indication of your allergies which would assist UCC or medical staff in the event of illness? Yes No If yes, please explain: 5 Are you currently taking any medications? Yes No If Yes, please explain: 6 Have you had any injuries, surgeries, diseases or ailments in the past five years? Yes No If Yes, please explain: 7 Is there any additional information (concerning medical conditions or mental, learning or physical disabilities) that would require action in the event of a medical emergency or be helpful for the programme to be aware of during your study abroad experience? Yes No If Yes, please explain: Declaration