STEP 1 - Trip Information
Number of Travellers:*
Province of Residence:*
Date of Birth - Primary:*
Coverage Type:*
Trip Start Date:*
Trip End Date:*
Number of trip days:
Does your trip destination include the USA?*
Do you have valid coverage under a Government Health Insurance Plan (eg OHIP) or a University Health Insurance Plan for the duration of your trip?*
Do you reside in Canada and have not yet departed on your trip?*
If you would like to be quoted Emergency Hospital & Medical, please fill in $0 in the Trip Cost per Traveller.

Trip Cost per Traveller (optional)
(Canadian Funds, no decimals)