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TRAVEL INSURANCE QUESTIONNAIRE

e.g. insulin for diabetes, aspirin for strokes, Paracetamol for back pain , having regular check-ups? or under investigation, waiting on a diagnosis or surgery?
Kidneys, Liver / Cancer (even if in remission) / Joint, back or spine / Brain e.g. Dementia, Epilepsy, head injury, Tumours / Any heart-related condition e.g. Angina, bypass surgery, heart attack, irregular heart rhythms, stents / Strokes e.g. clots, Deep Vein Thrombosis, mini strokes, Pulmonary Embolism / Respiratory system e.g. Chronic Bronchitis, COPD, Emphysema
Have there been complications with this or a previous pregnancy? / Is it a multiple pregnancy e.g.twins or triplets ? / Was the conception medically assisted? e.g. using assisted fertility treatment including hormone therapies or IVF ?(Pregnancy cover is limited to unexpected complications up to the 24th week. Childbirth or care of a newborn is not covered)
YOUR PERSONAL MEDICAL INFORMATION IS CONFIDENTIAL BETWEEN YOU AND YOUR CONSULANT BUT MAY NEED TO BE SHARED WITH THE INSURANCE COMPANY OR TRAVEL PROVIDERS WITH YOUR PERMISSION

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on any of our services or special offers.