Doctor Registration

We need you to complete the following form accurately so we can book flights and make all the other arrangements for your expedition asap.

Forename(s) as Per Passport*
Surname as Per Passport*
Email*
Phone*
Passport Number*
Nationality*
Country of Birth*
Place of Issue*
Date of Issue*
DD slash MM slash YYYY
Date of Expiry*
DD slash MM slash YYYY
Date of Birth*
DD slash MM slash YYYY
Medical Council/GMC Number*
Gender*
Next of Kin Name*
Next of Kin Phone Number*
What is Their Relationship with You?*
Do you have any medical allergies, illnesses, injuries or are you currently taking any medication?*

We need this information in the case that you fall ill and require first aid treatment from the expedition leader.
Do you have any Dietary Restrictions?*
*
- . I have read the expedition itinerary and to the best of my knowledge I am fit and healthy enough to partake in the entirety of this expedition.
We highly recommend obtaining your travel insurance with Trailfinders. To obtain a quote and book insurance with Trailfinders please click here.*
- . I understand I need to obtain travel insurance which covers me for this expedition.
We highly recommend obtaining your travel insurance with Trailfinders. To obtain a quote and book insurance with Trailfinders please click here.
Please contact your medical indemnity insurance provider asap to obtain confirmation that they will cover you.*
- . I confirm it is wholly my responsibility to obtain and pay for medical indemnity insurance which covers me for this expedition.
Please contact your medical indemnity insurance provider asap to obtain confirmation that they will cover you.
*
- . I have read the doctor file and I am clear on what the expedition doctor role entails and what is expected of me.
*
- . I confirm I am familiar with altitude medicine and I have read and understood the CDC paper on Altitude Illness.
*
- . I confirm I am familiar with all of the medical equipment and medication supplied by Earth’s Edge including the correct dosages, potential side effects and reactions. I confirm that I will research the destination myself and I will carry any additional medicines I feel are needed over and above what is supplied by Earth’s Edge. I confirm I will check and make sure that the medical equipment and medication supplied by Earth’s Edge is present and in working order prior to departure. It is exclusively my responsibility to decide when and to whom to give medical care to on the expedition.

Earth's Edge

Unit C28 Wicklow Enterprise Park, The Murrough, Wicklow

patrick frawley ★★★★★ in the last week

Just back from Everest Basecamp I can not recommend Earths Edge enough , from our lead Mike and doc Sam to all in Napal nothing was a problem. If your planning on a trip Earths Edge are the company to deal with . 10 out of 10 thank you … More so much Pappy Frawley

Leeanne Thompson ★★★★★ a month ago

Climbing Kilimanjaro with Earths Edge was an amazing experience. Their expedition includes a doctor which was super helpful during it. Also their guides and porters have so much experience and they also bring lots of energy and enthusiasm … More to help get to the top.

Elaine ★★★★★ 2 months ago

Highly recommend Earths Edge. Booked Kilimanjaro trip with them. The whole process was very easy from dealing with team in Ireland right through to landing in Tanzania. The guide Fredy was brilliant and the assistant guides/porters Gabriel, … More Kesi, Edson, Abu Mama, Fuso, Goodluck, Salama, their personalities, singing and positive vibes defo made us all get to the top. Chef Eric's food was top notch. Really comforting having Arav the doctor there for advice. Really nothing but a positive experience.

We are a 'work from home' business. The below address is a postal address only.

Unit C28, Wicklow Enterprise Park, P.O. Box 8, The Murrough, Wicklow, Ireland

IE: +353 1 532 0869
UK: +44 1 905 57 0391
US: +1 508 644 8365
support@earths-edge.com

4.9 168 reviews

patrick frawley ★★★★★ in the last week
Just back from Everest Basecamp I can not recommend Earths Edge enough , from our lead Mike and doc Sam to all in Napal nothing was a problem. If your planning on a trip Earths Edge are the company to deal with . 10 out of 10 thank you … More so much Pappy Frawley
Leeanne Thompson ★★★★★ a month ago
Climbing Kilimanjaro with Earths Edge was an amazing experience. Their expedition includes a doctor which was super helpful during it. Also their guides and porters have so much experience and they also bring lots of energy and enthusiasm … More to help get to the top.
Elaine ★★★★★ 2 months ago
Highly recommend Earths Edge. Booked Kilimanjaro trip with them. The whole process was very easy from dealing with team in Ireland right through to landing in Tanzania. The guide Fredy was brilliant and the assistant guides/porters Gabriel, … More Kesi, Edson, Abu Mama, Fuso, Goodluck, Salama, their personalities, singing and positive vibes defo made us all get to the top. Chef Eric's food was top notch. Really comforting having Arav the doctor there for advice. Really nothing but a positive experience.

Doctor Registration

Doctor Registration

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