Travel Risk Assessment

If you are travelling abroad please complete and submit the travel form at least two months before your journey. To help the Travel Nurses assess your travel needs it is important that they are in receipt of the assessment form before your appointment.

Travel Risk Assessment

Please use this date format: DD/MM/YYYY.
Please use this date format: DD/MM/YYYY
Please use this date format: DD/MM/YYYY
Please write your name. For discussion when risk assessment is performed within your appointment. I have no reason to think that I might be pregnant. I have received information on the risks and benefits of the vaccines recommended and have had the opportunity to ask questions. I consent to the vaccines being given.