Intake Form - Rancho La Puerta
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At The Ranch, you can relax and unwind, knowing that we are prepared to address your needs. We ask that all guests complete this intake form to help us ensure you have the best possible experience.

Please fill out and submit the form below in advance of your visit.

Medical Intake

Medical

Are you pregnant?

Please consult with your physician before reserving your stay, especially if you will be in your 3rd trimester during your visit. Remember, we are located in Mexico and the nearest US hospital is approximately 1½ hours from the property.

Are you taking any medication for any condition?

Remember to pack 14-days of medication in original bottles with labels.

Have you had any injuries within the last year?
Have you had any surgeries, including cosmetic within the last year?
Do you have any skin conditions?
Do you have any implants (i.e. pacemaker, joint replacement, etc.)
Do you have any walking issues or any condition that would impair your ability to walk?
Guests are expected to walk on average of 4 miles a day on hilly, uneven terrain that includes winding pathways with ramps and steps. It is important to consider any balance or cognitive issues.

Dietary

Do you have any food intolerances, including allergies?
Are any of these allergies life-threatening?
Please remember to travel with your Epi-Pen.
Do you have any dietary preferences?

Please check in with our Maitre´d upon arrival to discuss how we can best accommodate your restrictions.

Enviromental

Do you have any allergies to soaps, fragrances, oils, skin care products, etc.?
Do you have any environmental or insect allergies?
Are any of these allergies life-threatening?

Please be sure to travel with an Epi-Pen.

Additional Information

 

If you have any questions, please email our staff physicians at firstaid@rancholapuerta.com or call them directly at 858-925-1214 ext. 630.