Making an Appointment for Travel Medicine Consultation for Travel Abroad

First Steps:

Carefully check your travel program paperwork
Answer all questions completely
Click the submit button

All fields marked with asterisk (*) are required.

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What is your full name and college ID #*

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What is your complete itinerary (list all countries, provinces, cities that you will be visiting either with your program or on your own before or after the program dates)?*

required date field

What is your departure date from U.S.?*

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What is your return date to the U.S.?*

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Who is sponsoring your travel abroad program?*

Purchase College

SUNY (other than Purchase)

Private Program

Personal Trip

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Does your program require you to have a physical exam?*

Yes

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What is the deadline for submission of paperwork?*

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Who is your health insurance provider?*

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Where is your primary care provider's practice? (City and State)*

Link (required)

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