ONE PER TRAVELLER TRAVEL ADVICE Going Abroad on Holiday or Business? You may need travel vaccinations, depending on the country or countries that you intend to visit. To help advise you on the protection you need, please get advice at least 3 months before you travel, as some complicated regimes may require three or more appointments. NAME: ___________________________________ Address: _________________________________________________________ Telephone Number(s): DOB: ______________ _____________________ _____________________ Which countries do you intend to visit (including brief stopovers)? It is helpful to give as much detail as possible: ________________________________________________________________________ ________________________________________________________________________ _________________________________________________________ Will you be staying in hotels or under more primitive condition (e.g. camping)? ___________________________________________________________________ Are you visiting friends or relatives? YES □ NO □ Do you plan any safaris, jungle exploration or travel in difficult terrain? ________________________________________________________________________ ________________________________________________________________________ _________________________________________________________ Departure Date: Duration of stay abroad: _________________ _________________ Have you ever had any of the following vaccinations and if so when: Typhoid Tetanus Polio Hepatitis B □_______________ □_______________ □_______________ □_______________ Are you allergic to anything? Yellow Fever Diphtheria Hepatitis A Cholera □_______________ □_______________ □_______________ □_______________ ________________________________________ Are you taking any medicines? There is no need to list medication you have on repeat prescription but please include any medicines you buy yourself in pharmacies: ________________________________________________________________________ ________________________________________________________________________ _________________________________________________________ Remember: if you are receiving any medication, make sure that you take enough supplies to last through your overseas visit. ONE PER TRAVELLER Immunisations Required Doses Dip/Tet/Polio Hepatitis A Thyphoid Hepatitis B Meningitis A C W Y Japanese Type E Encephalitis Tick Borne Encephalitis Rabies Cholera (Dukorel) Yellow Fever* BCG** Malaria Drugs Required Free of charge Free of charge Free of charge Prescription cost £20 + Pharmacist charge Prescription cost £20 + Pharmacist charge Prescription cost £20 + Pharmacist charge Prescription cost £20 + Pharmacist charge Prescription cost £20 + Pharmacist charge Prescription cost £20 + Pharmacist charge Not available in the surgery – travel clinic Not available in the surgery – travel clinic Prescription cost £20 + Pharmacist charge You may be advised to take more than one antimalarial drug. Chloroquine and Proguanil are available from pharmacies without a prescription. You will need a prescripiotn for malarone, doxycycline and mefloquine. If you have been given a choice of two or more antimalarials you should discuss your choice with a doctor either by making an appointment or by telephone. Antimalarials are not available on NHS prescription. The pharmacy will charge for the drugs *Yellow Fever available from: **BCG available from: Edinburgh Travel Clinic Superdrug Health Clinic Davidson Mains Medical Centre Edinburgh Travel Clinic If you wish you can attend any of the Travel Clinics listed below: Edinburgh Travel Clinic 14 East Preston Street Edinburgh EH8 9QA 0131 667 1030 Superdrug Health Clinic 83 Princes Street Edinburgh EH2 2ER 0845 026 0830 Western General Hospital Crewe Road South Edinburgh EH4 2XU 01131 537 2822