Travel Questionnaire

If you require any vaccinations relating to foreign travel you need to fill in a travel questionnaire at least 8 weeks prior to travel. A downloadable form is available at the bottom of this page. Please print off and hand in at reception. A nurse will then ring you to discuss your needs and make appointments as required. 

Notice

For vaccinations it is important to make initial contact with us as early as possible - at least 8 weeks before you travel - as more than one appointment with a Practice Nurse may be required.  Many vaccines have to be ordered in, as they are not regular stock items.  Your last appointment needs to be at least 2 weeks before you travel to allow the vaccines to work.

Some travel vaccines are ordered on a private prescription and these incur a charge over and above the normal prescription charge.  This is because not all travel vaccinations are included in the services provided by the NHS.

If you are travelling in less than 8 weeks, you can contact The MASTA Travel Clinic in Plymouth on 01752 205556 for advice. Alternatively call 0330 100 4106 for The MASTA Travel Clinic - Lloyds Pharmacy (in Sainsburys) Roundwell, Barnstaple, Devon, EX31 3NH. 

Please note - you should always ring these clinics before attending.

Gender/Sex
Have you taken insurance for this trip?
Please tick ALL that apply
Please provide details of your personal medical history
Please tick ALL that apply
Are you pregnant?
Are you breast feeding?
Are you planning pregnancy while away?
Have you had the following vaccines in the past?
Please tick ALL that apply