Travel Risk Assessment

If you are travelling abroad please make sure you contact us in plenty of time to arrange any vaccinations that may be necessary. To help the Travel Nurses assess your travel needs it is important that they are in receipt of the assessment form before your appointment.

Please see our Travel Advice page for more information.



In line with guidance from the British Medical Association, we regret to advise that we are unable to provide GP letters or complete travel cancellation forms for those patients with pre-arranged holiday plans who choose not to travel but are not unwell.

Insurers and travel companies should be basing their decision to offer refunds on advice from the Foreign and Commonwealth Office and Public Health England.

Patients will no doubt have good and sensible reasons for not wanting to travel to certain places because of COVID-19, but this is not the same as being unable to travel due to existing illness.

Documentation will be provided for those patients who are unable to travel due to genuine illness.

Travel Risk Assessment

Travel Risk Assessment

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.
Please use this date format: DD/MM/YYYY
Please use this date format: DD/MM/YYYY
Holiday type:
Type of trip:
Staying in area which is:
Planned activities:
Including diabetes, heart or lung conditions
Have you ever had a serious reaction to a vaccine given to you before?
Does having an injection make you feel faint?
Do you or any close family members have epilepsy?
Do you have any history or mental illness including depression or anxiety?
Have you recently undergone radiotherapy, chemotherapy or steroid treatment?
Have you taken out travel insurance and if you have a medical condition, informed the insurance company about this?
Have you ever had any of the following vaccinations / malaria tablets?

Please state which year you had the vaccination(s):