Travel Risk Assessment

Travel vaccines take varying lengths of time to confer maximum protection and therefore need to be given well in advance of the date of travel. Therefore Travel Health Questionnaires need to be submitted at least 6 weeks prior to travel.

Due to appointment capacity and the need to continue providing essential services such as the childhood immunisation programme, cancer screening and wound care etc. travel health appointments are limited to one patient per day.

Alternatively there are independent Travel Clinics and some Pharmacies offering these services privately.

Travel Risk Assessment

Travel Risk Assessment

Please use this date format: DD/MM/YYYY
Please use this date format: DD/MM/YYYY
Holiday type:
Type of trip:
Accommodation:
Travelling:
Staying in area which is:
Planned activities:
Including diabetes, heart or lung conditions
Have you ever had a serious reaction to a vaccine given to you before?
Does having an injection make you feel faint?
Do you or any close family members have epilepsy?
Do you have any history or mental illness including depression or anxiety?
Have you recently undergone radiotherapy, chemotherapy or steroid treatment?
Have you taken out travel insurance and if you have a medical condition, informed the insurance company about this?
Have you ever had any of the following vaccinations / malaria tablets?

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

*