Form - Sanitas Estudiantes Internacional

On-line contracting form

Get your insurance quote:

Select your age range:

Select your zone

Name & Surname *

Gender *

Man
Woman

Nationality *

Date of Birth *

Document Type *

Document Nº *

Height *

Weight *

Policy start month *

Policy duration *

Mobile phone *

Other phone (optional)

Email *

Street, number, floor, door: (address of residence in Spain) *

Province

Municipality

Postal code

Payment Method

Bank transfer
Credit or debit card

Payment frequency

Sanitas Intenational Students

Exclusive insurance agency Sanitas DGSFP registration code No. 14040