Pre Travel Assessment Form
If you are travelling and require vaccinations, please complete the below travel form and either email or hand into reception. The nurses will review the form and arrange appropriate appointments and order vaccinations as required.
Please note that we require at least 8 weeks' notice before travelling so if your trip is going to be within the next 8 weeks please contact one of the clinics listed below.
Information submitted through secure forms is used only for the purposes of processing your request. We may
be in touch with you in relation to the information submitted.
All Information submitted through secure forms is secured with a private key and is accessed over a secure
connection by nominated staff. We have a strict confidentiality policy.
This information is not shared with any third party organisations.
This information is retained for up to 28 days.
Should you have any concerns about sending your personal details using the web,
please use one of the alternative methods offered by our organisation.