Traveling
abroad?

Travelling requires planning, especially when you use medication or travel to other continents. Sometimes you need to declare your medication by showing customs a list of the medication you are using. The list can be obtained from your pharmacy or by printing a list which you can find in your 'uwzorgonline'-app. We can sign this list if needed.

Information about medication abroad? See link .
Need assistance at the airport? You don't need anything from your doctor, see link .

Need advise or vaccinations for your next trip? Fill out the form below.
Travel form
Fill out the form below to ask for travel and vaccination advise
Date of birth
Sex
TRAVEL DETAILS
Date of departure
VACCINATION DETAILS
Have you been vaccinated before?
Have you had any problems after the vaccination?
Do you have a (yellow) vaccination booklet?
Have you taken malaria pills before?
MEDICAL DATA
Are you suffering from a serious illness?
Are you under the supervision of a specialist?
Do you have (or have you had) one or more of the conditions below?
Do you have depression or psychological problems?
Do you have diabetes mellitus (diabetes)?
Do you have Psoriasis?
Do you have Epilepsy?
Do you have Heart Desease?
Do you regularly take medication?
Do you have Hepatitis?
Are you taking the pill?
Are you pregnant?
Do you have HIV/AIDS?
Do yo have Lung diseases?
Are you breastfeeding?
Do you have Stomach/intestinal complaints or operations?
Do you have any allergy?
Do you have any Kidney diseases?
Bedankt voor het invullen van het formulier.

We nemen contact met u op, als u binnen 3 dagen niets hoort, neem dan zelf contact op.
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