Travel Risk Assessment

If you are travelling abroad please make sure you contact us in plenty of time to arrange any vaccinations that may be necessary, we require a minimum of 8 weeks notice to allow time for booking and for any vaccines to be effective. To help the Travel Nurses assess your travel needs it is important that they are in receipt of the assessment form before your appointment.

Please note that only the vaccinations for Hepatitis A, Typhoid, Diphtheria, Tetanus and Polio are available on NHS prescriptions.

Please complete the form below to get more information about what travel immunisations you require. Most vaccines are given at least 2 weeks before travel, and some more complicated regimes take longer. Please try to give us prior notice (preferably 6 weeks).
Title
Date of Birth
Address
Email
Women Only: Is there any possibility you may be pregnant?
Destination(s)
UK Departure Date
Please enter a number from 0 to 99999.
Further Information
Purpose of your trip
Holiday type
Accommodation
Setting
Planned Activities
Are you fit for travel?
Do you have any allergies?