Our Services

Personal Information Form

Using our online form to transmit your personal details allowing us to complete your application for international health insurance,
not only are you doing this in an utmost secure manner (SSL) - verified by 'Let's Encrypt' - but also sending us just the information required.
This saves valuable time for all involved, allowing you to focus on the more important things in life.

Step 1 of 3 - About yourself

Personal Details
Please provide full details
Add your Teams name for easier and quicker consultations!
Banking Information
Name of bank
German IBAN is always 22 digits (e.g. DE91 1000 0000 0123 4567 89)
Only if different to policy holder!