Travel Questionnaire

Travel Questionnaire

Personal Details

Name

Date of Birth

Telephone number

NHS number if known (optional)

What destination(s) are you travelling to?
Travel Information

We only provide the following four vaccinations on the NHS

Do you need the Hepatitis vaccination?

Yes

No

Do you need the Typhoid vaccination?

Yes

No

Do you need the Cholera vaccination?

Yes

No

Do you need the Polio vaccination? (given as a combined tetanus, diphtheria and polio vaccination)

Yes

No

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Page last reviewed: 24 September 2026