Print these forms and complete them prior to your appointment because it will save you time. Remember to put them in the car, your backpack or your purse so that you won’t forget to bring them with you.
- SPTM Patient Registration Form
- SPTM Payment Policy
- SPTM Patient Vaccine and Medicine Waiver
- SPTM Checklist for Consultation
What to Bring to Your Appointment
- Your travel itinerary. This is imperative to our providing you with the most effective information necessary for your safe and healthy travel. It is helpful to have the exact names of the provinces and cities to which you will be traveling, as our database provides endemic tropical disease updates, current outbreak information, and political status on a city-by-city basis.
- Description of the types of activities you will be undertaking and any possible side excursions you are considering.
- List of current medications being taken. We need to know everything that you are taking, including: prescription medications, over-the-counter medications, vitamins, and nutritional supplements. Be sure to make note of the dosage of each medication.
- History of any allergies. These may include food, drugs, insects, plants, pollens, animals, chemicals, etc.
- Your immunization history. Prior to presenting for consultation, you should check with your primary care provider to review your recent immunizations. For example, have you received influenza vaccine or Pneumovax, and when was your last tetanus booster (Td vs Tdap)?
- Immunization records for children birth to 18 years of age. These are required because we will not administer immunizations to children ages birth to 18 years without their prior immunization record.
- Your International Certificate of Vaccination or Prophylaxis, otherwise known as your “yellow card”, if you have one. Not everyone will have a “yellow card,” but if you need one, we can supply it.
- Essential information about your medical history or medical conditions so that we can understand any underlying conditions that may impact your care.
- We accept Cash, Visa, MasterCard, Discover, American Express and all debit cards.
- We do not accept personal or business checks as form of payment. Per our credit card agreement, we cannot accept third party credit card transactions. The primary cardholder must be physically present at the time of service for payment to be accepted.
- Please note that, unfortunately, preventive travel medicine services are not commonly covered by health insurance plans. You will need to check directly with your insurance carrier to verify if your plan covers preventive medicine for travel purposes.
- We will provide you with a complete and detailed statement of medical services for you to submit to your insurance carrier, including Medicare, for possible reimbursement. Safe Passage Travel Medicine, P.C. is a private professional corporation that is not contracted with any health insurance companies and is not required to and does not accept any form of health insurance as payment for services rendered. When you submit a claim, the processing of your claim(s) will be a transaction directly between you and your insurance company.
Pre-Travel Counseling and Immunizations
Safe Passage Travel Medicine offers two options for pre-travel consultation. Fees listed below cover consultation only; immunization prices vary and are totaled separately.
Comprehensive Counseling Option and Fees
Travelers may meet for private or semi-private (maximum 3 people) counseling with our Nurse Practitioner. Services include:
- Comprehensive pre-travel health and vaccine counseling specific to the destination
- Political and safety information, including embassy phone numbers
Consultation Fee: $45, $58, or $100, depending on the length of time, number of travelers, and complexity of the visit.
All charges, including consultation fees, are subject to change.
Self-selected Immunization Option and Fees
Travelers may make an appointment for self-selected immunizations. The traveler assumes responsibility for his/her vaccinations and does not want Physician or Nurse Practitioner involvement.
Fee: Cost of pre-travel immunizations. Additional fees will be incurred if clinical advice is necessary for anti-malaria medication selection, written prescriptions for anti-diarrhea medications, or written prescriptions for antibiotics.
To schedule an appointment please call 404-297-9755.
NOTE: Because the prices of our immunizations are subject to change, please verify the cost at the time you schedule your consultation or with our patient care coordinator during your consultation visit to the office.
Should you return home suffering from an illness or injury acquired during your trip, Safe Passage Travel Medicine can provide the knowledge and care you need for a speedy recovery. Each of our five physicians is board-certified in both infectious disease and internal medicine, and we manage the DeKalb Medical Comprehensive Wound Care Center. If you need to be seen urgently we can work you into the schedule to be examined by one of our physicians.