Travel questionnaire

This questionnaire will help us to give you appropriate advice about your proposed travel plans. We offer NHS vaccines only. For any private vaccines, please contact a pharmacy or travel clinic.

Fields marked with a red asterisk * are compulsory. By using this form you will be sending information about yourself across the internet. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you, then you should use the paper equivalent which can be obtained from reception. Personal information retained on this system is treated as confidential.