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 note, we ask for 6-8 weeks notice before travelling. If less time is given you may be directed to a private travel clinic where charges will apply.

Travel Risk Assessment

Section

Please use this date format: DD/MM/YYYY
Please use this date format: DD/MM/YYYY
Type of travel and purpose of trip (please tick all that apply):
Including diabetes, surgery or transplants, heart or lung conditions, blood conditions etc.
Including prescribed, purchased or a contraceptive pill

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