Complete Our Pre-Travel Questionnaire

At Palliser Medical & Travel Clinic in Lethbridge, we make it easy for you to get started with our services by providing our pre-travel questionnaire online. This questionnaire is to be filled out by each traveler and turned in to our clinic at least 2 to 3 days prior to your travel consultation appointment. You can return it to us by fax, email or in person.

Please also be sure to contact the community health office(s) where you have received your vaccinations and have them fax your records to us. Other things to keep in mind prior to your appointment include:

  • Please schedule consultation at least 6 weeks ahead
  • The costs of travel vaccines are not covered by Alberta Health Care
  • The consultation fee is $50 per person
  • Missed appointments will be billed if not cancelled 2 days ahead of your scheduled appointment

The Questionnaires

Choose the format below that is compatible with your system:

Questionnaire in Microsoft® Word 2010 format

Questionnaire in plain text

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