Health inventory

download fillable .pdf

Health inventory

Please help us in serving your needs effectively by filling out this health inventory form.

NOTE: This is a confidential record of your medical history and will only be used in case of emergency while you are traveling with Extend Global. This record will be destroyed immediately upon your return from your mission outreach. You will be asked to fill out a new form for each trip. 


You can fill out the form then mail in the printed .pdf version to our address found here.

Please email us if you have any questions!