The Cranborne Practice Travel Risk Assessment v3

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 be aware that we require at least 8 weeks notice before you travel to allow time for your vaccinations.

 

This form was updated in January 2026.

Your Details







Trip details

Please supply information about your trip in the section below.









Trip Description



Please supply details of your personal medical history

If you answer "Yes" to any of the questions below, please provide further details in the box provided. 



























Vaccine and Malaria treatment history





The information you provide on this form will be sent to our practice and used only to deal with your request. Depending on the form, this may include your contact details, personal information and health information. The practice may add it to your medical record and, where needed for your care, share it with other NHS and care services. To find out how we protect and use your information, please read our privacy policy on our website.

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Page last reviewed: 08 January 2026
Page created: 14 October 2026