If you are travelling abroad and require advice and/or vaccinations you will need to download the travel vaccination and enquiry form (see below) which you should complete and hand in to reception. Once the form has been completed in full and returned to us you can make an appointment with the nurse. Alternatively it can be completed online below. The form should be submitted and the appointment arranged 6-8 weeks before you travel to ensure that any course of vaccinations required can be appropriately completed and be considered effective.
Please click here to download the travel vaccination form (PDF, 253KB) including details of our current charges for vaccinations.
All payments can be made by cash, cheque or visa. Travel vaccination charges where these apply will need to be paid on the first visit and for any courses these are non-refundable.
Please note there is currently a national shortage of Hepatitis A&B vaccine so the practice cannot provide these at the present time. The nurse will advise you if these vaccines are available alternatively you can consult with a local private travel clinic.
Travel risk assessment and enquiry form – to be completed by the traveller 6-8 weeks prior to travel and prior to an appointment being made with the nurse.
Please provide details about your personal medical history below:
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 and is accessed over a secure
connection by nominated staff. We have 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
Shotfield Medical Practice
Shotfield, Wallington, Surrey, SM6 0HY.
Should you have any concerns about sending your personal details using the web,
please use one of the alternative methods offered by our organisation.