Health Questionnaire & Personal Release Form

This is a multi-page form. Please note that you may save your work and return to this page to complete your entry at a later date.  

If you have receive error messages or have difficulty completing the forms, please try a different browser (e.g., we find that Internet Explorer is the most reliable browser over others such as Firefox).

It is essential that you let Animas Valley Institute staff know of any medical condition(s) that may affect your ability to participate in a program.  In particular, let us know of any medications that you will be taking.

General Information

Fields marked with a * are required

(we use this information to assign rooms not for health purposes)

Click “Save Progress” if you need to exit the questionnaire
and want to return to it at a later date to complete it.