TRAVEL RISK ASSESSMENT FORMS

To be completed by patients travelling abroad.

Please print this form and HAND in to a Receptionist at Ainsdale Medical Centre.

Please DO NOT post forms to the Surgery as an appointment is necessary upon completion of the form.

Thank you.

Please give five weeks notice for travel vaccinations.

Patients requesting vaccinations within one month of travel will be asked to contact the School of Tropical Medicine:

• Liverpool School of Tropical Medicine
  Pembroke Place
  Liverpool L3 5QA
  Tel: 0151 705 3100

Click here to download a travel advice sheet.