Are you travelling within 6 weeks? 

YES – Unfortunately we will be unable to accommodate your request for a travel assessment. You will need to contact a local travel clinic. Sorry for any inconvenience.    

NO – Please complete the form below and it will be passed on to the Practice Nurse for review.     

Please note that the practice will only be able to vaccinate you with vaccines that are provided by the NHS. Currently we are unable to offer Yellow Fever, Rabies, Japanese Encephalitis and in some cases Hep B.

The Fit for Travel website contains lots of useful information, regarding travelling abroad.

Travel Form
Enter Email
Please use format day/month/year e.g. 12/05/1979
Please use format day/month/year e.g. 12/05/2019
Please use format day/month/year e.g. 12/05/2019

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.