Introduction
Tell your agency where you are going, when, and who is traveling. Your agency uses these details to ask its insurance partner for a quote. This form is not a quote or a policy, and it does not recommend cover.
Trip AgencyForms
Travel insurance quote form: the trip details your agency passes on
A travel insurance quote form gathers the trip details your agency needs before it asks an insurance provider for a quote: the dates, destinations, traveler ages and the estimated trip cost. It does not produce a quote, compare policies or recommend cover, and it is not a substitute for the provider's own application. Keep health information out of this form, and follow the provider's process for anything it needs.
What people search
Travel insurance quote: 12,100 average monthly searches.Google Ads Keyword Planner · 2026-10-09 · United States
Words for the respondent
What this form does and does not do for a traveler
Confirmation
Thank you. We have your details. Your agency will contact you about the quote through the channel you chose. Please do not send health information or card details in this form.
Total trip cost in US dollars
Enter an estimate for the whole trip, including flights and lodging. An estimate is enough at this stage.
Traveler ages
Enter the age of each traveler in years, separated by commas. Do not enter dates of birth.
Coverage you want quoted
Choose what you want the agency to ask about. Your agency or its provider decides what cover is suitable.
Questions to leave out
Information this form should not collect
What is your full date of birth?
Traveler ages are enough for an initial request. Ask for dates of birth only when the provider's process requires them.
Which policy is the best one for you?
The form does not recommend cover. The agency or the provider explains the options, and the traveler decides after reading the policy wording.
Can we apply for the policy on your behalf today?
The form does not place an application. The traveler reviews the provider's application and wording before agreeing to it.
Field blueprint
Trip details an insurance quote request needs
| Field | Type | Required | Why you ask it |
|---|---|---|---|
Lead traveler name | Short text | Required | The person the agency contacts about the quote. Use the name on the booking. |
Email address | Required | Where the agency sends the quote, or its questions about missing details. | |
Phone numberUse the country code, for example +1. | Phone | Optional | For a call about missing details. |
Trip start date | Date | Required | The first day of the trip. Quotes depend on the trip dates, so the start date comes first. |
Trip end date | Date | Required | The last day of the trip. With the start date, it sets the length of cover to quote. |
DestinationsEnter one country per line, not cities, where you can. | Long text | Required | The countries or regions the trip covers. Providers can price regions differently. |
Number of travelers | Number | Required | Sets how many people the quote request covers. |
Traveler agesFor example: 34, 36, 9 | Short text | Required | Age bands can change a quote, so ages are needed. Dates of birth are not. |
Total trip cost in US dollars | Number | Required | Some providers ask for an estimated trip cost before they quote. An estimate is enough at this stage. |
Coverage you want quotedTrip cancellationMedical expenses abroadBaggageNot sure, ask the provider | Multiple choice | Optional | Lists the cover types to ask about. Your agency or the provider decides which one is suitable. |
Trip booking statusBookedPartly bookedNot booked yet | Single choice | Required | Some providers quote differently before and after a booking, so the agency needs the status first. |
Notes for your agencyLeave out medical information and identity numbers. | Long text | Optional | Captures trip details the form does not cover. |
Preferred way to hear backEmailPhone call | Single choice | Optional | Sets how the agency replies once the provider has answered. |
After a response arrives
Pass the details on without advising
Check the details against the booking
Compare the dates, destinations and traveler count with the booking record before you send anything to the provider. A mismatch means the quote has to be redone.
Use the provider's own route for the quote
Send the request through the provider's channel, and only where your agency is authorized to request quotes for that product. Share what the provider's process asks for, and keep the record in the trip file.
Read the grid, and call when the trip is close
Submissions are stored straight away, and the hourly production run then notifies the form's creator. Use the grid to review them, and phone the traveler once the trip gets close.
Frequently asked questions
Does this form give me a travel insurance quote?
No. This form collects the details your agency needs before it asks a provider for a quote. The quote comes from the agency or the provider, not from the form. If you are a traveler looking for a quote, ask the agency you are working with whether it offers one.
Does the form recommend a policy?
No. It does not compare policies or recommend cover. An agency that is authorized to advise does that in its own process, and the traveler should read the provider's policy wording before deciding.
What if the trip is a cruise?
List the ports and the cruise dates in the destinations and dates fields, and ask the provider how it treats ship-based trips. Some providers set their own rules for cruises, so name the ship's route in the request.
Is there a travel insurance quote form template I can download?
Copy only the trip details into any template: the dates, destinations, traveler ages, the estimated trip cost and the booking status. The provider's own application covers the rest, and health questions belong in its process rather than in your template.
What if the trip has not been booked yet?
Choose Not booked yet. Providers can quote differently before and after a booking, so check the rule with the provider rather than guessing what it will accept.
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How to build it
Choose a category and a form type in the wizard. Answer three Atty Suggestions questions, then give the form a title. Atty builds the fields in the background. Edit the fields and ask Atty to refine them, then publish and share the /f/ link.
