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Travel risk assessment form
Please use this date format: DD/MM/YYYY
Please write your name. For discussion when risk assessment is performed within your appointment. I have no reason to think that I might be pregnant. I have received information on the risks and benefits of the vaccines recommended and have had the opportunity to ask questions. I consent to the vaccines being given. I confirm that I have read and understood the Travel Advice.
Please use this date format: DD/MM/YYYY
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