Pre-consultation Intake Form

I am excited to work together with you!

Here is the next step for creating a beautiful travel experience! The information provided on this form will allow us to make the most of our 30 min complimentary consultation.

First Name (as seen on passport)

Middle Name (same as passport)

Last Name (same as passport)

Age at time of travel

Age can impact pricing for cruises, travel insurance, etc...

YYYY

For receiving booking confirmations

Phone

(###)

###

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Preferred Departure Airport

Trip description

Where are you dreaming of going and how many days? What is important to you on this trip? What does the pace look like?

Any medical conditions or accessibility needs?

I am a Special Needs Group Certified Accessibility Travel Advocate! Please let me know what will make your vacation more enjoyable and stress-free.

Any loyalty program memberships?

Number of Travelers in group

Relationship to primary contact

If you are the primary contact, type "self"

Emergency Contact

Include name and phone number

What elements of travel insurance protection are most important to you?

This will help me provide the most relevant quote. Trip protection covers cancellations, interruptions, medical emergencies, and more.

Trip Cancellations/Interruptions: Coverage for unexpected events like illness or emergencies that disrupt travel plans.

Medical Emergencies: Assistance with healthcare costs while abroad or out of network.

Flight Delays/Cancellations: Compensation for unexpected changes.

Lost or Delayed Luggage: Protection for belongings during transit.

Natural Disasters: Coverage for travel disruptions due to weather or unforeseen events.

CFAR: Cancellation for any reason

Peace of mind

Please acknowledge the following:

I acknowledge itinerary proposals may be presented as a bundled cost.

I understand there is a deposit to be paid following my trip consultation before work will begin on my itinerary proposal

Pre-consultation Intake Form

I am excited to work together with you!

Elevated Travel Destinations