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.

Travel Risk Assessment

Which surgery do you normally attend?

Section

Please use this date format: DD/MM/YYYY
Please use this date format: DD/MM/YYYY
Including diabetes, heart or lung conditions

If known, please state which year you had the vaccination(s):