Form

Rabies: pre-exposure request form

Request form for non-travel pre-exposure rabies vaccine.

From:
UK Health Security Agency
Published
10 August 2017
Last updated
24 January 2024 — See all updates

Applies to England and Wales

Documents

Pre-exposure rabies request form

Ref: Gateway number GOV-16070

MS Excel Spreadsheet, 94.5 KB

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Details

Please use this form in conjunction with the guidelines for requesting rabies pre-exposure prophylaxis.

Return the completed request form by secure email to PHE.ig.clerks@nhs.net

Published 10 August 2017
Last updated 24 January 2024 + show all updates

  1. Updated form.

  2. Updated form.

  3. Added revised version of the request form.

  4. Added new telephone number for Rabies and Immunoglobulin service.

  5. Added updated form (version 2) to accompany updated guidelines for requesting pre-exposure prophylaxis.

  6. Updated form to accompany updated guidelines.

  7. First published.

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