Pre-Travel Form
Please complete and bring the below form for each traveler scheduled to be seen at Penn Travel Medicine.
Completion of this form in advance will save time as this paperwork will not need to be completed upon arrival at any Penn Travel Medicine office.
Download Form
Prepare for Your Appointment
To make an appointment a patient may call 800-789-7366 or request an appointment via myPennMedicine.
To prepare for your appointment you should provide the following:
- Travel Medicine Pre-Travel Worksheet
- Destination of travel
- Symptoms of illness after travel
- Insurance information for post-travel visits for illness (Most pre-travel services are not covered by insurance, but cash payments are accepted.)
- A referral/authorization, if your insurance requires it
- Co-pay, if applicable