OBJECTIVE To assess the influence of giving patients a handout about tetanus immunisation on the rate of immunisation against tetanus among adults in a general practice. DESIGN Monthly tetanus immunisation rates were audited before and after the handout was introduced. SETTING A practice with six doctors and a list of 11,000 patients in an urban area of Hertfordshire. INTERVENTIONS In the first month reception staff were instructed to give a handout about tetanus immunisation to all adults presenting at the reception desk. In the next seven months the doctors used the handouts opportunistically during consultations. RESULTS No significant change in immunisation rate was detected in the first month in which the handouts were used. During the next seven months the median monthly rate rose threefold. CONCLUSION Handouts given to patients can increase the uptake of preventive services in general practice.