Somerville Medical Centre

69 Gorsey Lane, Wallasey, Merseyside, CH44 4AA

It's Thursday 3:38 AM — Sorry, we're closed

Telephone: 0151 638 9333

Pre-Travel Information

Before foreign travel it is always best to check if you need any extra vaccinations. You can do this by completing the form below, which will then be given to our specially trained Practice Nurses.

Holiday vaccinations are a 30 minute appointment at our surgery either Sister Claire Jones or Sister Anita Hayden. We recommend that vaccinations are given at least two weeks prior to travel.

For more information please visit www.smarter-traveller.co.uk or www.fitfortravel.nhs.uk.

Pre-Travel Vaccination Form

Full Name*
First Last
Date of birth*
Date Format: MM slash DD slash YYYY
Contact number:*
Do you have any allergies?*
If yes please specify
Have you ever experienced a reaction to a vaccine?*
If yes please specify
Have you ever undergone any surgery?*
If yes please specify
Have you ever had chemotherapy/radiotherapy?*
Have you ever had an organ transplant?*
Do you suffer with any medical conditions?*
If yes please specify
Do you take any medication (prescription/bought over the counter)?*
If yes please specify
Are you currently pregnant/breastfeeding?*
Please give any details of your vaccination history:
Date of departure*
Date Format: MM slash DD slash YYYY
Date of return*
Date Format: MM slash DD slash YYYY
Destination(s), Please specify if you are staying in a city/rural location*
Type of travel*
Purpose of travel*

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Opening Times

Monday
08:00 - 20:00
Tuesday
08:00 - 20:00
Wednesday
07:00 - 20:00
Thursday
08:00 - 20:00
Friday
07:00 - 18:30
Saturday
08:00 - 12:00 [PRE-BOOKED HUB APPOINTMENTS ONLY]
Sunday
CLOSED

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	Very good	Good	Average	Poor	Very poor
Giving you enough time
Asking about your symptoms
Listening to you
Explaining tests & treatment
Involving you in decisions about your care
Treating you with care and concern
Taking your problems seriously