Be rest assured that there was no need for any extra medical requirements for any of the shore visits. My wife and I are both in our earle sixties and although we took two organised tours we also took taxis from the dock in Cartagena and Jamaica. As I stated in my report it was a wonderful lifetime experience that we both would not have missed for the world. you must try and stay in san Francisco either before or after the cruise, it has the most relaxing atmoshere and wonderful fish restaurants. We stayed down near Fishermans wharf at the Tuscan Inn and I would recommend it for it's handiness to walk to all the tourist sites. Those people that we met who stayed on Knob Hill found it a long way going backwards and forwards to the wharf area. David and Susan O' Neill