Quote requests

How your information is used

This form collects your name and a way to reach you so the broker can discuss your emergency travel medical insurance enquiry.

What you can choose to share

Your phone number or email address is enough to request a conversation. Destinations, travel dates and traveller birthdates are optional. You can discuss them with the broker when you speak.

Who can see your enquiry

Your enquiry is stored in the website’s Cloudflare database and is available to Jacqueline Van Horn and authorized site administrators through the private dashboard. The information is used to respond to your request and discuss insurance options.

Medical information

Please discuss medical conditions directly with Jacqueline during your call. Do not enter medical records in the form or send them by ordinary email.

Contact and privacy requests

To ask about your enquiry, request a correction or deletion, or withdraw your request to be contacted, email [email protected] or call +1 (778) 554-5804. Jacqueline will explain any information that must be retained.

Website storage

The private dashboard uses a secure session cookie for sign-in. This website does not use advertising trackers. Request identifiers and limited technical information help prevent duplicate submissions and spam.