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 recommend you have your vaccines 8 weeks before you travel to ensure your body builds adequate immunity. It will also allow us to ensure we have the vaccines in stock and have a Practice Nurse appointment available.

The following vaccinations are provided free on the NHS.

  • cholera
  • hepatitis A
  • paratyphoid
  • poliomyelitis
  • smallpox
  • typhoid

 

A private travel clinic will be able to help you with any other vaccine not listed above. We cannot provide them here at the Practice.

Before you book an appointment with our Practice Nurse you must check the NHS Fit for Travel website to see what vaccinations are recommended for your trip.

Please complete the following form if you would like to book an appointment with the Practice Nurse. Once we receive your form, we will contact you to book an appointment.

Travel Risk Assessment

Travel Risk Assessment

Sex:
Please use this date format: DD/MM/YYYY
Please use this date format: DD/MM/YYYY
Holiday type:
Type of trip:
Accommodation:
Travelling:
Staying in area which is:
Planned activities:
Including diabetes, heart or lung conditions
Have you ever had a serious reaction to a vaccine given to you before?
Does having an injection make you feel faint?
Do you or any close family members have epilepsy?
Do you have any history or mental illness including depression or anxiety?
Have you recently undergone radiotherapy, chemotherapy or steroid treatment?
Have you taken out travel insurance and if you have a medical condition, informed the insurance company about this?
Have you ever had any of the following vaccinations / malaria tablets?

Please state which year you had the vaccination(s):

*