Travel Risk Assessment

We offer a full travel advice and immunisation service. If you are travelling abroad, please complete and submit a Travel Risk assessment form in plenty of time (minimum of 6-8 weeks) before your journey. Once you have returned your completed form, please allow 5 working days for the travel nurses to review. After the 5 working days, please call back so we can book you an appointment based on the nurses’ recommendations.

We are also a Yellow Fever centre.

Travel Risk Assessment Form
DD/MM/YYYY
Please let us know your preferred contact number in case we need to contact you.

PLEASE SUPPLY INFORMATION ABOUT YOUR TRIP IN THE SECTIONS BELOW

PLEASE SUPPLY DETAILS OF YOUR PERSONAL MEDICAL HISTORY

Women only

PLEASE SUPPLY INFORMATION ON ANY VACCINES OR MALARIA TABLETS TAKEN IN THE PAST

Sending