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Form – Outbound – RatesDotCa
Travel Guardian Web Admin
2020-10-23T10:38:15-05:00
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What kind of insurance are you looking for?
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Travel Medical
Optional
Both
Contact Person
Number of travellers
1
2
3
4
5
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8
Same as Contact Person
Province of residence
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Alberta
British Columbia
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Northwest Territory
Nova Scotia
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Destination
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Worldwide, including USA
Worldwide, excluding USA
Within Canada Only
Departure Date
Travel date is:
Confirmed
Tentative
Return Date
Number of Days
Are you planning on traveling
more than once
within a year from your departure date?
Yes
No
Do you have or have you ever had any pre-existing medical conditions?
Yes
No
Are you interested in purchasing any optional insurance?
Click Yes to see options
Yes
No
Trip Cancellation and Trip Interruption
Have not booked yet
Have not booked yet
Have not booked yet
Have not booked yet
Have not booked yet
Have not booked yet
Have not booked yet
Have not booked yet
Trip interruption
Baggage
AD&D
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Non-medical package
All inclusive
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