THE APOLLO GrouP
MUCH MORE LAN REST OD
INTERNATIONAL CRUISE SERVICES, SOCIEDAD LIMITADA
February 21, 2024
NGAKAN MADE DWIYANA.
Address: Ngakan Made Dwiyana, Putra, Indonesia
Re: Pre-Existing Conditions
Dear Mr. Usman,
We are in receipt of your Pre-Employment Medical Examination. The results of the
examination reveal the following pre-existing condition(s), which requires your personal
attention that may include maintenance medication and medical follow up
Hypercholesterolemia (elevated result of Cholesterol from level 258 mg/dl to level 164 mg/dl)
‘which may lead to complications resulting to cardiovascular diseases which may lead to heart attack
{and stroke and other illness or injuries related to pre-existing condition known or unknown at the time
this document was prepared. Crew will take full responsibility regarding health management.
‘Mild Eosinophilia- asymptomatic
Based upon the above reference medical examination, you have a pre-existing medical
condition(s), which requires you to take medication and/or assume personal responsibility to
‘manage the pre-existing condition(s) noted herein. As such, you will be responsible for follow
up appointments; medication and treatment require to treat the pre-existing condition(s). You
‘must bring with you to the ship enough medication, if any is needed, that must last you for the
duration of your contract plus one month. If you require any extra medication, you agree to
voluntarily repay your employer the cost of the medication. Please be advised that your
employer will not cover the cost of medication or treatment for the pre- existing condition(s)
described above and any associated complications that may arise from it and/or your failure to
manage it.
Furthermore, you agree, as part of your employment with the Company that you will take any
and all steps to control your pre-existing condition(s), obtain any necessary medication,
treatment required and take any other action, including but not limited to lifestyle changes, to
avoid an exacerbation of your pre- existing medical condition(s).
‘Your signature in the space provided below will acknowledge your receipt and understanding
Of this notice and that you have had an opportunity to discuss any questions or concems about
this notice with a member of a Medical Staff or other appropriate personnel. This also
confirms that information in the Pre- Employment Medical Forms are true and correct and
fully understand any failure in properly disclosing pre-existing medical and psychological
conditions can result in disciplinary action including but not limited to termination of
employment.
Sincerely,
Medical Department