Travel Questionnaire

Travel Questionnaire

If you are travelling abroad, please make sure you contact us in plenty of time to arrnage any vaccinations that may be necessary. To help the Travel Nurses assess your travel, it is important that they are in recepit of the assessment form before your appointment. Please be aware that we require at least 6 weeks notice before you travel to allow time for your vaccinations.

PLEASE CALL 01746 767121 48 HOURS AFTER SUBMITTING YOUR QUESTIONNAIRE

Your details






Travel Details




Travel Description







Personal Medical History














Vaccination History



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Page last reviewed: 29 January 2024
Page created: 08 November 2021