Pre-Travel Health Assessment

  • dd-mm-yy or dd/mm/yy
  • (A nurse will contact you if you are up to date with all vaccines required. Please therefore provide a daytime and mobile number.)

  • (The nurse will email all the relevant travel information & what type & length of appointment to make. Please ensure you check your spam/junk mailbox)

  • dd-mm-yy or dd/mm/yy
  • Past Medical History
    If you answer YES to any questions the Nurse will discuss this further at the time of your appointment.

  • This field is for validation purposes and should be left unchanged.