International Federation for East Timor
Observer Project

Medical Release Form

________________________________________ has applied to be a volunteer with the International Federation for East Timor's Consultation Project. If accepted for the project, s/he will act as an international observer for the historic United Nations administered vote in East Timor in August.

As ________________________________________'s doctor, I attest to the fact that s/he is in good physical condition. I understand that East Timor has a tropical climate and that due to the political situation, there will be a great deal of stress involved in their position as an Observer Project Volunteer.

Additional Comments:


Doctor's Name

Doctor's Signature

Candidate's Signature

Note: For Indonesia/East Timor, the following CDC web site should answer most questions:

They do not have, however, complete information on East Timor specifically. The recommendation for malaria prophylaxis for East Timor should be mefloquine or doxycycline, which is not clear from the site information.

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