Honeymoon Please Specify Voluntary Charity Work Trekking Accommodation Hotel/Cruise Family / Friends Home Planned Activities Safari Please Specify – Vaccination History Any Previous Vaccinations especially from another Practice – TRAVEL VACCINATION CHARGES As of July 2018 Vaccination Cost Yellow Fever £65.00 Certificate £13.33 + £2.67 Vat Total Cost £81 Hepatitis B 1st £47.00 2nd £26.00 Travellers Abroad 3rd £26.00 Booster £47.00 Meningitis Nimenrix £64.00 Travellers Abroad Rabies 1st £78.00 Travellers Abroad 2nd £62.00 3rd £62.00 Booster £78.00 Japanese Encephalitis Prices vary (~£107) For courses of three Please ask for details injections Tickbourne Encephalitis Prices vary (~£170) For courses of three Please ask for details injections To be completed by the Practice Nurse Additional Information National database consulted for travel vaccines recommended for this trip and malaria chemoprophylaxis (ire required): NaTHNaC: TRAVAX: OTHER:
Honeymoon Please Specify Voluntary Charity Work Trekking Accommodation Hotel/Cruise Family / Friends Home Planned Activities Safari – Please Specify Vaccination History – Any Previous Vaccinations especially from another Practice TRAVEL VACCINATION CHARGES As of July 2018 Vaccination Cost Yellow Fever Certificate Total Cost £65.00 £13.33 + £2.67 Vat £81 Hepatitis B 1st 2nd 3rd Booster £47.00 £26.00 £26.00 £47.00 Travellers Abroad Meningitis Nimenrix £64.00 Travellers Abroad Rabies 1st 2nd 3rd Booster £78.00 £62.00 £62.00 £78.00 Travellers Abroad Japanese Encephalitis Prices vary (~£107) Please ask for details For courses of three injections Tickbourne Encephalitis Prices vary (~£170) Please ask for details For courses of three injections To be completed by the Practice Nurse Additional Information National database consulted for travel vaccines recommended for this trip and malaria chemoprophylaxis (ire required): NaTHNaC: TRAVAX: OTHER:
travel-health-questionnaire-intranet.docx