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VernonMedical Clinic

Travel Medicine

Travel consultation form

The best way to book a travel consultation is to fill out this form. It generates an email enquiry to the practice and we will get back to you within 2 working days.

If you fill out this form and don't hear from us within 2 working days, please call the practice.

This form is for travel vaccine enquiries ONLY. For all other enquiries about non-travel related vaccines (such as flu, COVID-19, shingles etc.) please call us on 01 853 2070.

Your details
Your trip

Choose the day you leave and the day you return.

Just write 'None' if you have never had any.

We will do our best to accommodate those who are not patients of the practice.

Before you send

If you are not a patient of Vernon Medical Clinic, a deposit is required to hold your booking. This deposit is taken off your bill after your appointment. This deposit is not refunded if you cancel your appointment less than 48 hours before your appointment is due.

If you are travelling with other adults who also wish to have a travel consultation with us, they will need to fill out their own version of this form.

You will also need to fill out this form on behalf of anyone under 18 who is travelling with you and who wishes to book a travel consultation, so please take the time to do this if applicable.

I understand that filling out this form generates an email to the clinic and that you will contact me within 2 working days. If I don't hear back from you within 2 working days I will call the practice.