Pre-Travel Questionnaire

Please complete this questionnaire if you wish to book an appointment with the Travel Clinic.
You must complete a separate form for all travellers.

Please ensure that you disclose your past medical history and current medical conditions to ensure that we can make a full risk assessment and evaluation of your needs.
(Note, if you are completing this form within 8 weeks of your departure date we will NOT be able to offer an appointment for your vaccinations)

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Workplace Wellness is the trading name of Bradford on Avon Occupational Health Services Ltd.
Registered in England: 9749251
VAT no. 27144823278
Registered Office: 29 Bridge Street Bradford on Avon Wiltshire BA15 1BY

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