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. 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 read the Travel Clinic information on the Clinics and Services page before submitting this form.

Travel Risk Assessment

Travel Risk Assessment

Please use this date format: DD/MM/YYYY
Type of trip:
Accommodation:
Type of area:
Are you pregnant or trying to conceive? *
Have you reacted badly to any previous vaccine? *
Are you allergic to any medications? *

Declaration

*