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. Your completed form will be passed to the nurse for assessment. Should any vaccinations be required, the surgery will then contact you to make an appointment.

Travel Risk Assessment

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.
Please use this date format: DD/MM/YYYY
Please use this date format: DD/MM/YYYY
Including diabetes, heart or lung conditions

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