Thai Travel Clinic

Hospital for Tropical Diseases
Faculty of Tropical Medicine, Mahidol University

Travel Clinic Health Questionnaire
 
      At our travel clinic, you will be requested to fill a health questionnaire inquiring your general health status, history of allergy, previous vaccinations, as well as detail of your trip, etc. This information is necessary for our doctor to make a sound recommendation for you.
 
You may choose one of the following option to fill this form;
 
1. Fill it onine, make sure that you have already made an appointment OR
2. You could Download it as pdf (60kb) and fill it manually, then bring it with you OR
3. Download it as fillable pdf (332kb) then you could fill it with Adobe Reader then just email us. OR
4. Simply fill it at our clinic on your visit 
 
 
 
To fill Travel Clinic Health questionnaire online, click this link
 

Thai Travel Clinic, Hospital for Tropical Diseases,
Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Copyright © 2005-2017 Thai Travel Clinic. All Rights Reserved.