Booking & Payment Form

All fields are required to be completed

PLEASE NOTE:

I understand that my Destiny Medi-Travel Registration Fee of A$395.00 is payment for Destiny Medi-Trave’s Services and is not refundable.

If surgery date is within 30 days of receiving Registration and additional A$90.00 will be added for Late Payment. This is due to the Express priority services that I will require to leave within 30 days

I understand that Destiny Medi- Travel will make a Booking on my behalf only on receipt of the Booking Form & Disclaimer and Payment of A$395.00 Destiny Medi-Travel Registration Fee

I will pay my Travel/Accommodation account to MTA Travel 45 days prior to departure.

I understand that I pay the cost of my procedure and the Hospital Account after the pre surgery check. Unless advised otherwise

In relation to my booking confirmation I elect to utilise the following payment option.

Please complete the complete the required fields on each page, pressing Next to move between pages. When you have confirmed the details are correct on the last page then click on Proceed to Payment to make your credit card payment.

As your privacy is paramount to Destiny Medi-Travel - please refer to Destiny Medi-Travel’s Privacy Statement (click link below)

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