Travel Risk Assessment

For all risk assessments you must be an active, registered patient with Chapel Row Surgery.

With effect from 1st March 2022 there will be a £20 surcharge fee for any risk assessments submitted less than 4 weeks prior to departure.

This will be added to your invoice should you require any vaccinations.

We will aim to respond to you as quickly as we are able, please check your junk mail for replies. Once we have completed the assessments, we will advise you of any appointments that need to be made, please call Reception on 0118 971 3252 to book.

Travel Risk Assessment

Travel Risk Assessment

Please use this date format: DD/MM/YYYY.
Please use this format: DD/MM/YYYY
Are you flying direct to your destination?
Do you plan to travel abroad again in the future?
Have you taken out insurance for this trip?
Are you fit and well?
Are you pregnant or planning to conceive?
Are you allergic to anything?
Have you had a reaction to a vaccine before?
Are you immunocompromised?
Do you have a spleen?
Are you undergoing any treatment for cancer or waiting for surgery?
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