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PRE TRAVEL ASSESSMENT FORM Please complete and return to Lang more Clinic Mr Mrs Ms Dr Surname Date of Birth First names Occupation This trip is for Holiday Business Daytime phone Contact details:
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How to fill out pre-travel assessment:

01
Gather necessary information: Start by collecting all the essential details related to your travel plans. This may include the purpose of travel, destination, duration, mode of transportation, accommodations, and any specific requirements or preferences.
02
Review health and safety guidelines: Familiarize yourself with the health and safety guidelines relevant to your destination. This could involve checking travel advisories, researching on any required vaccinations or medications, and being aware of any health risks or precautions related to the location you are traveling to.
03
Complete personal details: Fill in your personal information accurately. This may include your full name, contact details, date of birth, passport information, and emergency contact information. Ensure that all the provided information is up to date and correct.
04
Medical history and current health status: Provide a comprehensive medical history, including any pre-existing medical conditions, allergies, recent illnesses, surgeries, or ongoing treatments. It is important to be honest and thorough in this section to ensure proper medical assessment and possible preventive measures.
05
COVID-19 related information: Due to the ongoing global pandemic, it is crucial to address COVID-19 related questions in the pre-travel assessment. This may involve answering questions about recent exposure to the virus, symptoms experienced, COVID-19 testing history, and vaccination status. Provide accurate information to enable appropriate health recommendations and precautions.
06
Special requirements: If you have any specific requirements, such as dietary preferences, mobility restrictions, or accessibility needs, make sure to mention them in this section. This will help facilitate a smoother and more comfortable travel experience.

Who needs pre-travel assessment:

Pre-travel assessment is needed for anyone who is planning to travel, regardless of the purpose or destination. It is particularly important for individuals embarking on international travel or those visiting areas with specific health risks. This includes tourists, business travelers, students studying abroad, government officials, volunteers, and individuals traveling for medical reasons. Pre-travel assessment helps in evaluating potential health risks, ensuring appropriate vaccinations or medications, and providing necessary health advice to enhance traveler safety and well-being. It is advisable for all travelers to undergo a pre-travel assessment to ensure a healthy and enjoyable travel experience.
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Pre-travel assessment is a process of evaluating an individual's health and travel history before embarking on a journey.
Pre-travel assessment is typically required for individuals traveling to high-risk areas or for those with specific health conditions.
Pre-travel assessment forms can usually be completed online or through a healthcare provider, providing details about travel plans and health history.
The purpose of pre-travel assessment is to ensure individuals are aware of potential health risks associated with their travel destination and to take necessary precautions.
Information such as medical history, current health status, travel itinerary, and vaccination records are typically required on a pre-travel assessment form.
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