Travel Risk Assessment

Travel Risk Assessment
Gender
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Are you currently pregnant?
Are you currently breast feeding?
Are you planning a pregnancy near travel?
Holiday type
Accommodation
Travelling
Staying in area which is
Planned activities
Have you ever had a serious reaction to a vaccine given to you before?
Does having an injection make you feel faint?
Have you recently undergone radiotherapy, chemotherapy or steroid treatment?
Have you taken out travel insurance and if you have a medical condition, informed the insurance company about this?
Have you ever had any of the following vaccinations / malaria tablets?
Declaration