TRAVEL CLINIC INFORMATION FORM
We are able to offer the following NHS vaccinations:
Diptheria, Polio, Tetanus 3 in 1 vaccine
For all other vaccines please visit your local travel clinic.
IMPORTANT - Please read the following notes before completing this questionnaire. Your vaccinations could be delayed if the form is not fully complete.
Please allow at least 4 weeks for your vaccination programme to be prepared. If your holiday is within 4 weeks please phone the surgery after 2pm on 01458 841122.
Section 1 - Personal Details
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