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Travel Risk Assessment Form

Prior to travelling, please allow as much time as possible to arrange your appointment for the Travel Clinic (preferably at least 6 to 8 weeks), which will be with the Practice Nurse. The Nurse will require to know which countries, and areas within countries, that you are visiting to determine what vaccinations are required.

Travel Risk Assessment
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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.

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