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Hampshire Health Record
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Travel Vaccination Form

Please be advised that we will not give any travel advice in relation to Covid19 restrictions and Covid19 vaccine rules. If you are travelling within 4 weeks of submitting this form, you will be referred to a travel clinic instead

Travel Vaccination Form
Please confirm you have read and understood the following:

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.


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