1a. Any specific hazards identified by the FCO in the Country/Countries visited? Yes No
2a. Any specific health requirements (e.g. vaccinations) for country/countries visited? Yes No
2b. If travelling in Europe has a E111 been obtained? (available on line from www.dh.gov.uk) Yes No
2c. Any health hazards identified by individual, e.g. prescription medication, allergies? Yes No
3a. Any other hazards identified, e.g. personal security? Yes No
