124 weber st south

UW Travel Clinic

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Daytime Phone Number *

Destination Country *

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Name + DOB ( DD/MM/YYYY) : *

Appointment request *

Email: *

Vaccines / Services Requested *

Travel Consult -$100 Single /

Travel Consult family -$180

New Patient to our Clinic

Repeat Patient to our clinic

Anti-Malarial Rx

Hep A Vaccine

Hep B vaccine

Typhoid Vaccine

Yellow Fever

Meningitis ACYW-135 vaccine

Travellers Diarrhea ( Dukoral ) Vaccine

Pneumonia Vaccine -Prevnar 20

ShingRix

Weight Loss / MVT / Lipotropic injections -$ 60

Other

Comments + OHIP card with Version Code

Waterloo , Ontario , Canada , N2J 2A7

Call -519 576 2680 - option 2 or 4

Email - info@uwtravelclinic.ca

Monday , Tues ,Thursday 9-5pm

Wed and Friday 9-12 noon

Closed Weekends and Holidays

Date of Travel and Destination

UW Travel Clinic | 124 Weber St S Waterloo ON N2J 2A7 CA | info@uwtravelclinic.ca