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Health Background
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Past medical history
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- Age
- Sex
- Underlying conditions
- Allergies (especially any pertaining to vaccines, eggs, or latex)
- Medications
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Special conditions
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- Pregnancy (including trimester)
- Breastfeeding
- Disability or handicap
- Immunocompromising conditions or medications
- Older age
- Psychiatric condition
- Seizure disorder
- Recent surgery
- Recent cardiopulmonary event
- Recent cerebrovascular event
- History of Guillain-Barré syndrome
- Severe allergies
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Immunization history
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- Routine vaccines
- Travel vaccines
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Prior travel experience
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- Experience with malaria chemoprophylaxis
- Experience with altitude
- Illnesses related to prior travel
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Trip Details
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Itinerary
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- Countries and specific regions, including order of countries if >1 country
- Rural or urban
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Timing
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- Trip duration
- Season of travel
- Time to departure
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Reason for travel
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- Tourism
- Business
- Visiting friends and relatives
- Volunteer, missionary, or aid work
- Research or education
- Adventure
- Pilgrimage
- Adoption
- Seeking health care (medical tourism)
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Travel style
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- Independent travel or package tour
- Propensity for "adventurous" eating
- Traveler risk tolerance
- General hygiene standards at destination
- Modes of transportation
- Accommodations (such as tourist or luxury hotel, guest house, hostel or budget hotel, dormitory, local home or host family, or tent)
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Special activities
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- Disaster relief
- Medical care (providing or receiving)
- High altitude
- Diving
- Cruise ship
- Rafting or other water exposure
- Cycling
- Extreme sports
- Spelunking
- Anticipated interactions with animals
- Anticipated sexual encounters
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