Travel

If you are travelling abroad, you may need vaccinations that will help keep you safe.

Some of these vaccinations are free on the NHS, and others you will have to pay for.

Our nurses can help you understand which vaccines you will need. Please fill out the form below and then ring the practice to book a travel advice appointment with a nurse.

Are you a registered patient at our practice?*
- Yes
- No
Sorry, this form is for registered patients only

We are not a private travel clinic and can only give advice to our registered NHS patients.
Name*
First Surname
Date of Birth*

Day
Month
Year
When are you travelling?*
Please give dates, as specific as you are able to.
What country or countries are you visiting?*
What sort of area(s) are you visiting?*
Select all that apply
- Urban
- Rural
- High altitude
What vaccinations have you previously had?*
Be as specific as you can, and include dates where possible.
Do you have any known allergies?*
(Including to previous vaccinations)
Have you ever had a serious reaction to a vaccine?*
- Yes
- No
What vaccine(s) did you react to?*
Please include dates, what type of reaction you had, and any other relevant information.
Email
This field is for validation purposes and should be left unchanged.

Travel

Sorry, this form is for registered patients only

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