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MEDICAL FORM MIUT 2026
Medical Form EN
Personal Data Protection Policy:
https://www.grupohpa.com/en/hpa-heath-group/personal-data-protection-policy/
PERSONAL DATA
*
1.
Bib number
(Obrigatório.)
*
2.
Nationality
(Obrigatório.)
*
3.
Name
(Obrigatório.)
MEDICAL FORM
4.
What medication do you usually take?
*
5.
Diabetes?
(Obrigatório.)
Yes
No
*
6.
Respiratory disease?
(Obrigatório.)
Yes
No
If yes, which one?
*
7.
Epilepsy?
(Obrigatório.)
Yes
No
*
8.
High Blood Pressure?
(Obrigatório.)
Yes
No
*
9.
Heart Disease?
(Obrigatório.)
Yes
No
If yes, which one?
10.
If you have food and/or drug allergies, please describe
*
11.
Have you had any major injuries since 2025?
(Obrigatório.)
Yes
No
