Please complete the following form to request immunisation appropriate to your travel plans. Alternatively please click here to download the form and return the completed form to the surgery.
If you have not already done so, please make a 20 minute appointment to see the Practice Nurse. Please allow 10-14 working days in between returning the form and visiting the Nurse. This will ensure that we have reviewed the information provided, researched the most current recommendations for the countries you intend to visit and have the relevant vaccines available for your appointment.
It is your responsibility to make an appointment with one of our Practice nurses in time for your foreign travel. Bear in mind that some vaccines take 2-4 weeks to build protection; and some vaccines, for example, Hepatitis B require several doses over a period of weeks or months.
If you are pregnant or likely to be pregnant when you travel, or are travelling with young children, your needs will be more complex so please book your appointment even earlier.
The NHS website www.fitfortravel.nhs.uk is an excellent source of information on how to reduce your risk of travel related illnesses. You are advised to refer to this website before your appointment.
Please bring any travel and childhood vaccination records to your appointment if possible. Also bring your travel itinerary to your appointment to establish whether you will be in a malarious area, and if so which medication is recommended. If anti-malarial medication is advised we can provide you with a private prescription at a cost of £18 and you can then purchase the mediation at a pharmacy of your choice.
We do not offer Yellow Fever, Japanese Encephalitis, Rabies or Meningitis ACWY vaccines. If these are required you will need to contact a specialist travel clinic.
Should you require any further information, please do not hesitate to contact us.
Information submitted through secure forms is used only for the purposes of processing your request. We may
be in touch with you in relation to the information submitted.
All Information submitted through secure forms is secured with a private key known only to the GP practice and is
accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.
This information is not shared with any third party organisations.
This information is retained for up to 28 days.
Should you have any concerns about sending your personal details using the web,
please use one of the alternative methods offered by our organisation.