Travel Risk Assessment

If you are travelling abroad please make sure you contact us in plenty of time (we recommend 6 weeks) to arrange any vaccinations that may be necessary.

Once this form is completed, it is passed to the practice nurse and then a member of the reception team will contact the patient to advise & arrange appointment where necessary.

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
Please write your name. For discussion when risk assessment is performed within your appointment. I have no reason to think that I might be pregnant. I have received information on the risks and benefits of the vaccines recommended and have had the opportunity to ask questions. I consent to the vaccines being given.