Travel Risk Assessment

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When planning foreign travel, first please visit Travel Health Pro details of vaccinations needed and general travel health advice.

If vaccinations are needed, these may be available from us as a private service, or from a travel clinic, e.g. Masta Travel Health

  • The surgery does not provide travel vaccinations for Rabies, Japanese Encephalitis, or Cholera and will need to be sourced in a travel clinic.
  • The surgery does provide Yellow Fever and Hepatitis B Vaccinations please refer to price list on our website.
  • Malaria tablets are available from pharmacies.

If you would like us to provide your vaccinations, please phone reception on 01235 517760 and ask for a travel appointment with one of the nurses, and complete this form.

Personal Details

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.

Please double check you've entered the correct email address
May be used to identify you
Dates and Trip Details
Vaccination Requirements
Personal Medical History
Including diabetes, heart or lung conditions
Signed & Dated

This form is automatically dated upon submission.

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.


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