Travel Clinic

Our specialised nurse runs weekly clinics offering travel advice and the necessary immunisations.

All patients need to complete the Travel Advice form below. This means one for every child or adult who are travelling. Once the forms are submitted and have been reviewed by our Travel Nurse. You will be contacted with an appointment.

The surgery is able to offer the Yellow Fever vaccination at an additional cost. There may be some additional costs for some other vaccines and prescriptions.

For further information on travel vaccines please visit: https://www.nhs.uk/conditions/travel-vaccinations/ and for advice on foreign travel based on destination, please see: https://www.fitfortravel.nhs.uk/destinations.

Travel Questionaire

Travel Vaccination Form

Please complete the form below to get more information about what travel immunisations you require.

Most vaccines are given at least 2 weeks before travel, and some more complicated regimes take longer. Please try to give us prior notice (preferably 6 weeks or more).

Once the form has been submitted, it will be reviewed by our travel nurse and an appointment will be issued.

This form should be completed and submitted, for each person travelling, including any children.

Title *
Address *
Address
Town
County
Post Code

 

Travel Plans

Have you had Travel Vaccines before?
Have you ever had an allergic reaction to a vaccine?
Further Information
Purpose of your trip *
Holiday Type *
Accommodation *
Setting *
Planned Activities *
Do you have Travel Insurance? *

Medical Information

Are you fit for travel? *
Do you have any allergies? *
Is there any possibility you may be pregnant? *
Are you using any Contraception? *
Are you planning on getting pregnant within 6 months of travel?
Are you breastfeeding?
Have you ever had a blood clot in your leg (DVT) or lung (PE) before?
Will you be travelling for more the 5 hours?
Do you have low immunity because of a medical condition or medication?
Will you be travelling with any prescription medicines from your doctor?
Will you be travelling with any Controlled Medicines prescribed by your Doctor?
Will you be travelling with any over the counter medicines?
Are you allergic to eggs?
Are you allergic to latex?
Do injections make you feel faint or nervous?
Have you checked any websites for travel advice? (e.g. NaTHNaC Travel)
Do you require a "fit to fly" letter from your GP? (Please note there is a charge for this).
Do you need a letter from your GP confirming your prescription medications? (Please note there is a charge for this).