Travel Medicine Consultation Note

Template structure

This is the structure Notat follows when it writes the note from the visit — you never fill it in by hand.

Travel Medicine Note

Patient Identification: [Patient name, age, gender, with a history of..., presenting for travel medicine consultation regarding travel to...]

Travel Itinerary:
(hyphenated list)
- [Destination(s)]
- [Duration of travel]
- [Purpose of travel]
- [Departure date]
- [Return date]
- [Urban/rural areas, accommodations, planned activities]

History of Present Illness:
[Reason for travel medicine consultation, including any specific concerns or exposures anticipated]

Past Medical History:
(hyphenated list)
- [Chronic medical conditions]
- [Previous travel-related illnesses]

Medications:
(hyphenated list)
- [Medication name, dose, route, frequency]

Allergies:
(hyphenated list)
- [Drug, food, environmental allergies]

Immunization History:
(hyphenated list)
- [Routine vaccinations]
- [Travel-specific vaccinations received]
- [Vaccinations due or recommended]

Family History:
(hyphenated list)
- [Relevant family medical history]

Social History:
(hyphenated list)
- [Tobacco use]
- [Alcohol use]
- [Recreational drug use]
- [Occupation]
- [Living situation]

Physical Examination:
(hyphenated list)
- [Vital signs with units in one line] (e.g., HR: #, BP: #, T: #, RR: #, O2 sats: #%)
- [Relevant physical exam findings]

Investigations:
(hyphenated list)
- [Investigation results with units] (Only include completed investigations, otherwise leave blank. All planned or ordered investigations should be included under Plan)

Assessment & Plan:
[One-sentence summary including age, sex, and reason for travel medicine consultation]

#) [Assessment as a numbered item if multiple issues]
(hyphenated list with each corresponding plan item on a new line)
- [Recommended vaccinations]
- [Malaria prophylaxis]
- [Other prophylactic medications]
- [Counselling on food and water safety]
- [Counselling on insect precautions]
- [Counselling on travel health risks (e.g., altitude, heat, injury prevention)]
- [Referrals sent]
- [Follow up plan]
- [Return precautions]