Worldwide Emergency Travel Services

• About this Benefit

Assist America/ Worldwide Emergency Travel Services can help you if you are traveling more than 100 miles from home within the US or abroad and need assistance. Click on the links to the left for more information about this benefit or call 800-872-1414 (US)/+1-609-986-1234 (outside of US). Please us reference number: 01-AA-UN-762490


Send form to:

Assist America/ Worldwide Emergency Travel Services, Inc.

202 Carnegie Center, Suite 302 B

Princeton, NJ 08540

Tel: 800-872-1414 Fax: 609-452-2042

www.assistamerica.com

  • About this form:

Assist America/ Worldwide Emergency Travel Services can help you care for your adult child (over 18) if they are traveling more than 100 miles from home within the US or abroad and need assistance.

If your child is under 18 and needs medical treatment, the minor's private medical information must be provided to the parent. But at 18, when the child becomes an adult, the Health Insurance Portability and Accountability Act of 1996 (HIPAA Law) requires that Assist America/ Worldwide Emergency Travel Services keep private medical information acquired from or about the adult child. The parent does not have an independent right to be informed by Assist America/ Worldwide Emergency Travel Services.

Before they leave for their trip, the adult child must sign and submit this authorization form to Assist America/ Worldwide Emergency Travel Services permitting the sharing of private health information with the parent.