Travel Risk Assessment

We now only provide three NHS Travel Vaccines:

Hepatitis A 
First Dose – protection one year
Booster Dose – Protection 25 years
Typhoid
Single Dose – protection three years
Diptheria/Tetanus/Polo 
Single Dose – protection 10 years

Please fill in the travel form if you need any of the above in plenty of time (we recommend 6-8 weeks) before your journey. For all other vaccines please contact your local private travel clinic.

Travel Risk Assessment

Travel Risk Assessment

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.
Gender:
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):

*