The form below is required by the Department of Natural Resources, depending of Ministry of Environment of the Government of Mendoza. This authority manages the Aconcagua Provincial Park entrance.
Please complete the entire form so INKA Expediciones manages your entrance permits.
Thank you.

Personal Information

Name
last Name
Date of Birth
Sex
Type of ID
ID Number
Nacionality
Phone Number
Fax
Mobile
Email

Address

Street
Number
Apartment Number
Floor Number
Zip Code
City
State / Province
Country of residence

In emergency case:

Name
Relationship
Email
Tel/Fax
Mobile

Insurance company

Company Name
Type of Insurance
Policy Nº
Email
Tel / Fax
Mobile

Medical Information

Blood Group
Have you ever suffered from any of these conditions?
Hypertension NOYES
Type of Hypertension
Hypertension Medicine
Allergies NOYES
Type of Allergies
Diabetes NOYES
Type of Diabetes
Smoking NOYES
Daily Nº of cigarettes
Breathing problems NOYES
Type of Breathing problems
Cardiac condition NOYES
type of Cardiac condition
Seizures NOYES
Date of last convulsion (DD/MM/YY)
Pregnancy NOYES
Time of pregnancy
Did you take some medicine? NOYES
Medicine description
Spine problems NOYES
Previous Luxations NOYES
Did you use glasses? NOYES
Acute Mountain Sickness (AMS) NOYES
High Altitude Pulmonary Edema (HAPE) NOYES
High Altitude Cerebral Edema (HALE) NOYES
Are you under medical supervision? NOYES
General Health
How high do you currently reside?
Height reached walking in the mountains
Other health condition?

Alimentation

What is your diet?

Diet Appreciations

Note: At Inka Expeditions our cooks perform a varied and nutritious menu to satisfy the energetic requirements of mountain activities. We have the possibility to adapt our menus to other pre-established according to the dietary restrictions of each client. Please be aware that any specific food wish to eat on the mountain must be provided by you. If you choose to bring from your country of origin, please get advice from regarding the entry of food regulations of Argentina and specific prohibitions of Mendoza.
(Mendoza) Iscamen www.iscamen.com.ar
(Argentina) Senasa www.senasa.gov.ar


Experience

Summits until 5000m

Summits until 6000m

Summits until 7000m

Summits more than 7000m