Travel Risk Assessment

Please ensure you make arrangements to see the travel clinic at least one month before you travel, otherwise we CANNOT GUARANTEE you will be offered an appointment in time for 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.

Please view the BMA Tourism Guide.

Please visit www.fitfortravel.nhs.uk, look up your destination(s) and pay specific attention to information regarding:

  • Prevention of Accidents
  • Personal Safety and Security
  • Food and Water bourne Risks
  • Travellers’ Diarrhoea
  • Sexual health and Blood bourne Virus
  • Rabies Advice
  • Mosquito Bite Prevention
  • Malaria Prevention Advice
  • Medical Preparation
  • Sun and Heat Advice
  • Journey/Transport Advice
  • Insurance Advice

If you are a late traveller, while we will make every effort to accommodate you, we cannot guarantee that we will be able to process your risk assessment document and we may advise you to go to a private travel company for your vaccinations.

Travel Risk Assessment

Travel Risk Assessment

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.
Gender: *
Please use this date format: DD/MM/YYYY
Please use this date format: DD/MM/YYYY
Holiday type:
Type of trip:
Accommodation:
Travelling:
Staying in area which is:
Planned activities:
Are you fit and well today? *
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? *
Do you or any close family members have bleeding/clotting disorders (including history of DVT)? *
Do you have heart disease (e.g. angina, high blood pressure)? *
Do you have liver and/or kidney problems? *
Do you have HIV/Aids? *
Do you have immune system condition? *
Do you have neurological (nervous system) illness? *
Do you have rheumatology (joint) conditions? *
Do you have respiratory (lung) disease? *
Do you have spleen problems? *
Do you have anaemia? *
Have you had any surgical operations, including your spleen or thymus gland removed? *
Have you recently undergone radiotherapy, chemotherapy/organ transplant? *
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):

*