Travel Clinic MD


adult immunization form

New Client
(Travel) Form

If you are a new client in need of travel advice and immunizations, please download, print, and complete our new client form before your appointment.
New Client Form

Download the form as a pdf file

Adult Immunization Form

If you are a new client in need of routine adult immunizations (not travel immunizations), please download, print, and complete the immunization form before your appointment.
Adult Immunization Form 

Download the form as a pdf file

Yellow Fever Immunization

Yellow fever vaccination is recommended for persons over 9 months of age travelling to or living in areas with endemic yellow fever.  Our clinic administers yellow fever vaccination to children, parents / guardians and adults travelling solo.

Download relevant Stamaril forms before visiting our clinic:
child  | patient guardian  | adult

Note: Adobe Acrobat Reader is required to view any of the above forms. Click here to get your free copy of Adobe Acrobat Reader.


The Travel Advisory & Immunization Clinic does not accept any insurance.
Payments must be made when services are rendered.
We accept cash, major credit cards and checks no more than $200.00. 

Find Us

2301 Research Blvd, Ste 125
Rockville, MD 20850
T: 301.738.6420 | F: 301.990.3534

The Travel Advisory and Immunization Clinic is accessible through an EXTERIOR entrance on the South Side of the building

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