BBC Health News

Music 'calms nerves before surgery' as well as sedative19 Jul 2019 00:36The "world's most relaxing song" could be just as good at calming patients' nerves, a study suggests.
Plant-based milks on the rise: A quarter of Britons are drinking them19 Jul 2019 06:46Whether it's almond, soy or coconut it seems cow's milk is being ditched for alternatives.
NHS boss: Tax bills could mean 'loss of 60 doctors'19 Jul 2019 16:00Doctors' refusal to work overtime is the issue, its chief executive warns.
Measles outbreak: Loddon head teacher makes immunisation plea18 Jul 2019 18:57Loddon head teacher Jim Adams writes to parents after three pupils contract the disease.
Wolverhampton hospital's 'regret' over new mum's death19 Jul 2019 15:22The trust running Wolverhampton's New Cross says lessons have been learned to better manage sepsis.
UTI home-testing app to help women trialled by NHS18 Jul 2019 17:28The app guides users through a urine test and allows the results to be analysed online by a pharmacist.

Travel Vaccinations

If you require any vaccinations relating to foreign travel you need to make an appointment with the practice nurse to discuss your travel arrangements. This will include which countries and areas within countries that you are visiting to determine what vaccinations are required. There is further information about countries and vaccinations required on the links below

Europe & Russia	Central America
Africa	North America
Central Asia	South America
East Asia	Carribean
Middle East	Australasia and Pacific

It is important to make this initial appointment as early as possible - at least 6 weeks before you travel - as a second appointment will be required with the practice nurse to actually receive the vaccinations. These vaccines have to be ordered as they are not a stock vaccine. Your second appointment needs to be at least 2 weeks before you travel to allow the vaccines to work.

Some travel vaccines are ordered on a private prescription and these incur a charge over and above the normal prescription charge. This is because not all travel vaccinations are included in the services provided by the NHS.

In addition to the NHS travel information and immunisation service we also run a private Travel Clinic, primarily for patients not registered at Moorside Surgery. This is run in conjunction with MASTA (a leading UK network of Travel Clinics) as 'Yorkshire Travel Clinic':

Appointment Details

Appointment datePlease provide in the format DD/MM/YYYY

Appointment timeHH:MM

2 Your Details

Title

First Name(s)

Surname

Home Address

Postcode

Home Phone Number

Mobile Phone Number

Work Phone Number

Date of BirthPlease provide in the format dd/mm/yyyy

3 Your Travel Arrangements

What date are you leaving the UK?Please provide in the format DD/MM/YYYY

Is the trip holiday or work?

4 Destination(s)

Please give details of which countries and areas you are visiting along with the dates of your stay.

Country 1

Name

Which area are you staying in? (Please be exact)

Please give dates of your stay

Please give details of your accommodation (hotel, private house, camping etc)

Country 2

Name

Which area are you staying in? (Please be exact)

Please give dates of your stay

Please give details of your accommodation (hotel, private house, camping etc)

Country 3

Name

Which area are you staying in? (Please be exact)

Please give dates of your stay

Please give details of your accommodation (hotel, private house, camping etc)

Will you be visiting more than three countries?

Are you stopping elsewhere en-route?

5 Previous Immunisations

Please state whether you have had the following immunisations, along with the date given.

Tetanus

Ever Had?

Typhoid

Ever Had?

Cholera

Ever Had?

Rabies

Ever Had?

Hepatitis A

Ever Had?

Polio

Ever Had?

Meningitis

Ever Had?

Yellow Fever

Ever Had?

Hepatitis B

Ever Had?

Diphtheria

Ever Had?

Please give details of any other vaccinations you have received

6 Further Information

Have you had any antibiotic treatment in the last 8 weeks?

Have you suffered from depression or any other psychiatric illness?Further info: certain anti-malarial tablets can, in a small percentage of people, exacerbate epilepsy or Psychiatric illness.

Do you have epilepsy?

Do you have medical problems requiring regular medication or check ups?

Have you taken any steroids or had immunosuppressive therapy e.g. chemotherapy in the last 3 months?

Are you allergic to any medicines?

Have you ever reacted badly to any vaccine?

Are you pregnant or planning a pregnancy in the next 6 months?

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 known only to the GP practice and is accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to
Moorside Surgery • 370 Dudley Hill Road, Bradford , BD2 3AA.

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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