Congratulations! You are just a few steps away from becoming a GMAP telemedicine member. After you have completed this form, you will be contacted by a member of our sales team and then prompted to schedule your virtual appointment with a VIGILINT physician.

Reminder: For family memberships and for adults 75 years and older, please contact our Global Client Services team at


For online sign up, GMAP memberships are available for individuals, their spouses or domestic partners.

Please plan ahead! Travel Medical Kits will be shipped within 7-10 business days after the initial intake.

Choose an amount

Subtotal $3,345.00

Total Amount: $3,345.00

*Aeromedical Evacuation: Adults over 75 years of age are required to submit a medical note and subject to additional charges