General Medical Consultation
Aeromedical Exam
Driver License Medical Exam
Preventive Care Consultation
Travel Medicine Consulation
Vaccinations
Patient's Provision
Initial Exam
Revalidation/Renewal
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Salutation
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Ms.
Family
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First Name
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Last Name
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Social Security Number
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Phone
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E-Mail
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Age
Destination(s)
Planned activities
Start of journey
Travel duration
Exam class
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Class 1
Class 2/LAPL
Class 3/ATCO
Cabin Crew
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Exam type
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Initial Exam
Revalidation/Renewal
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Vaccination against Tick borne encephalitis (TBE)
COVID-19 vaccinations with the new KP.2 variant vaccine (from the 6th month of life)
Influenza with the 2024/2025 seasonal vaccine (no age limit)
Hexavalent vaccine against Diphtheria, Tetanus, Pertussis (Whooping Cough), Hepatitis B, Poliomyelitis (Polio), and Haemophilus influenzae type b (up to the 6th birthday)
Diphtheria, Tetanus, Pertussis (Whooping Cough), and Poliomyelitis (Polio) (between the 6th and 15th birthday)
Measles-Mumps-Rubella (no age limit)
Rotavirus (up to the age of 24 weeks)
Hepatitis B (between the 7th and 15th birthday)
Pneumococci (up to the 2nd birthday)
Meningococci ACWY (between the 11th and 12th birthday)
Human Papillomavirus (HPV) (between the 9th and 30th birthday)
Follow Up Vaccinations/Booster Vaccinations
I am not sure
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