My Travel Clinic Agency Application Form


To request the addition of your agency to our "Travel Agencies" page, please complete the following 2 steps:

1. Copy and paste any ONE of our badge codes, listed below, into a page or header/footer on your website.

My Travel Clinic Light Badge (100x100)
My Travel Clinic Dark Badge (100x100)
My Travel Clinic Link

My Travel Clinic:
Counseling and immunization services for travelers

2. Complete the following form to notify us about the badge addition.

Please make sure that the information you submit is in a format that you would like to see on our website (consistent capitalization, phone number format, etc.).

Required Fields*







xxx-xxx-xxxx


http://

(Address where you placed the My Travel Clinic badge or link.)
http://


Verify

 
book online

Please select your
travel destination region:

travel clinic