All of the information on the forms you fill in is SSL encrypted and will only be available to the Emergency call center you agree to send it to.

Please fill in this form with your health history.

When you are finished, click SUBMIT.

If you want to fill out the same form for family members or others you may be traveling with, click I NEED ANOTHER FORM.

When you are finished, click SUBMIT.

If you DO want your health information to be automatically sent to the Emergency call center by email when you click the red Emergency button, at the bottom of the form click “Ok to send”.

If you DO NOT want this form to be send automatically, do not click “Ok to send”.

If you change your mind later and want to send it, you need to go back to the form and click “Ok to send”.

To change information or add another form, you need to go to the American Express TravelSafeWorld® website: https://www.travelsafeworld.com and then login so you can do so.

Again, all of your log in, personal health information and friends/family contacts are fully encrypted to prevent any third party from accessing this information.