Cartmel Surgery - Travel Vaccinations

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Useful Resources

BBC Health News

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Brain function of night owls and larks differ, study suggests15 Feb 2019 00:37Late risers have poorer attention, slower reactions and increased sleepiness, a study suggests.
A&E waits at worst level for 15 years in England14 Feb 2019 11:53Nearly 330,000 A&E patients waited for more than four hours last month in England.
'Know your cholesterol like you know your Pin code'14 Feb 2019 00:54Going for a free health check could flag up early signs of cardiovascular disease, health bodies say.
Chemicals 'repair damaged neurons in mice'14 Feb 2019 16:30Some early studies in mice suggest drugs can be developed to halt mental decline, say scientists.

Travel Vaccinations

If you require any vaccinations relating to foreign travel you need to make an appointment with the practice nurse to discuss your travel arrangements. This will include which countries and areas within countries that you are visiting to determine what vaccinations are required.

There is further information about countries and vaccinations required on the links below

It is important to make this initial appointment as early as possible - at least 6 weeks before you travel - as a second appointment will be required with the practice nurse to actually receive the vaccinations. These vaccines have to be ordered as they are not a stock vaccine. Your second appointment needs to be at least 2 weeks before you travel to allow the vaccines to work.

Some travel vaccines are ordered on a private prescription and these incur a charge over and above the normal prescription charge. This is because not all travel vaccinations are included in the services provided by the NHS.

Travelling in Europe

If you are travelling to Europe the EU has published useful information for travellers on the European website.

Appointment Details

Appointment datePlease provide in the format DD/MM/YYYY

Appointment timeHH:MM

2 Your Details

Title

First Name(s)

Surname

Home Address

Postcode

Home Phone Number

Mobile Phone Number

Work Phone Number

Date of BirthPlease provide in the format dd/mm/yyyy

3 Your Travel Arrangements

What date are you leaving the UK?Please provide in the format DD/MM/YYYY

Is the trip holiday or work?

4 Destination(s)

Please give details of which countries and areas you are visiting along with the dates of your stay.

Country 1

Name

Which area are you staying in? (Please be exact)

Please give dates of your stay

Please give details of your accommodation (hotel, private house, camping etc)

Country 2

Name

Which area are you staying in? (Please be exact)

Please give dates of your stay

Please give details of your accommodation (hotel, private house, camping etc)

Country 3

Name

Which area are you staying in? (Please be exact)

Please give dates of your stay

Please give details of your accommodation (hotel, private house, camping etc)

Will you be visiting more than three countries?

Are you stopping elsewhere en-route?

5 Previous Immunisations

Please state whether you have had the following immunisations, along with the date given.

Tetanus

Ever Had?

Typhoid

Ever Had?

Cholera

Ever Had?

Rabies

Ever Had?

Hepatitis A

Ever Had?

Polio

Ever Had?

Meningitis

Ever Had?

Yellow Fever

Ever Had?

Hepatitis B

Ever Had?

Diphtheria

Ever Had?

Please give details of any other vaccinations you have received

6 Further Information

Have you had any antibiotic treatment in the last 8 weeks?

Have you suffered from depression or any other psychiatric illness?Further info: certain anti-malarial tablets can, in a small percentage of people, exacerbate epilepsy or Psychiatric illness.

Do you have epilepsy?

Do you have medical problems requiring regular medication or check ups?

Have you taken any steroids or had immunosuppressive therapy e.g. chemotherapy in the last 3 months?

Are you allergic to any medicines?

Have you ever reacted badly to any vaccine?

Are you pregnant or planning a pregnancy in the next 6 months?

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key known only to the GP practice and is accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to
Cartmel Surgery • Haggs Lane, Cartmel, Grange-over-Sands, Cumbria, LA11 6PH.

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