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VNA Travel Wise
 Preparing
for Your Visit to Our Travel Clinic
Please print and complete the Screening
Questionnaire. Be as thorough as possible and answer all of
the questions. Your immunization history and travel plans are
important in determining your travel needs. Some countries require
proof of specific immunizations before they will admit a traveler.
Note: the screening questionnaire requires Adobe
Acrobat Reader.
In addition to the Screening Questionnaire, please bring the following
(if possible):
• World Health Organization International Certificate of
Vaccination (WHO Yellow Book)
• Documentation of all your immunizations
• Travel itinerary with departure dates and all destinations
Our Travel Consultation will help identify the recommended or
required vaccines based on your travel destination.
The immunizations VNA Travel Wise offers are:
• Hepatitis A
• Hepatitis B
• Hepatitis A/B (TwinRx)
• Influenza
• Measles, Mumps, Rubella
• Meningitis
• Polio
• Rabies
• Tetanus/Diphtheria/Pertussis
• Japanese encephalitis
• Pneumonia
• Tuberculin skin test
• Typhoid
• Yellow Fever
Please contact us with any questions.
VNA Manager of Community Programs (248) 967-8751
VNA Community Programs Assistant (248) 967-8755
E-Mail: vna@vna.org
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