Aviemore Medical Practice

Aviemore Medical Practice

Muirton, Aviemore, PH22 1SY

Current time is 03:11 - Sorry, we're currently closed. Please call NHS 111

NHS

Telephone: 01479 810258

Fax: 01479 810067

Secure Email: nhsh.gp55911-admin@nhs.scot

Pre-Travel Health Questionnaire

Aviemore Medical Practice Travel Clinic

  • Personal Details

    One form to be completed for each person travelling:
  • Travel Details

  • CountryCityArrival DateLength of StayVisiting Rural Areas?Visiting the Coast?Visiting Mountains over 3000 ft 
    Please list the countries to be visited, including details of your destination and any stopovers (these should include short stays in airport terminals. Please fill in as much detail as possible as this helps the nurse to decide if you need anti-malaria tablets etc.
  • Medical Details

    Please tick any that apply.
    Please tick any that apply.
  • VaccinationDateVaccinationDate 
    Please add the vaccinations that you have had in the past together with the dates. If you cannot remember the exact date, just put in the nearest month and year. Please include Polio, Diphtheria, Tetanus, BCG, Men C/ACWY, Pneumococcus, Typhoid, Hepatitis A, Hepatitis B, Japanese B Encephalitis and any others.
  • If you have a record of your previous vaccinations, please take a photograph of it and upload it below, as we may not have your medical records up to date.

  • Drop files here or
  • This field is for validation purposes and should be left unchanged.