Travel Health Consultation

1. Patient Information

2. Eligibility Screening — Medical Directive

Inclusion Criteria (must confirm all three)

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Exclusion Criteria (any checked → REFERRAL REQUIRED)

3. Medical History & Allergies

4. Immunization History

Routine Vaccinations

Check each vaccine the patient has received and enter the most recent date.

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Travel Vaccinations — Previously Received

Record prior doses. Duration of protection guides whether a booster is needed today.

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⚠ Vaccination Gaps Identified

Select any routine gaps — these will appear in the physician note and patient summary.

Additional immunization notes

5. Trip Details

Itinerary

+ Add Destination

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6. Risk Assessment

6B. Yellow Fever Screening

Complete this section only if Yellow Fever risk was identified above. Implements the 4-step algorithm per SOP Section 16.5 and Medical Directive Appendix C.

Yellow Fever screening completed for this patient Show YF Screening ▼

7. Travel Vaccines — Plan

Check all vaccines being ordered. Auto-populated by Destination Analysis (Section 6), or select manually.

8. Travel Medications — Plan

Quantities are calculated automatically from trip duration and altitude days on note generation.

9. OTC Recommendations

10. Pharmacist