Travel Clinic Request Form

Please complete and return this form to travel coordinator. Once we receive and review this form we will contact you to schedule your travel consult visit.

You can also download this form here to send through fax at 404-256-1759.


Medical History

Please note that Travel Consults are not covered by insurance carrier. You will be require to self-pay for the visit and any vaccines if needed.

The portal is a convenient way to leave non urgent messages for the staff to communicate with your MD, the business office or our advocates. It is monitored during business hours on Monday thru Friday from 9AM to 4PM. It is not monitored on the weekends. Please call the office for any urgent concerns.