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Please use this form to receive an individual insurance quote or to send us a message.

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Male / Female *

Your name: *

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Your Email: *

Please briefly explain your current living situation and your citizenship: *

When will you be moving to Austria? How long are you planning on staying in Austria? *

In what region of Austria do you live / will you be living? *

Will you be working in Austria? If yes, what is your profession? *

Do you have / will you have public healthcare in Austria through ÖGK / SVS / BVAEB ? *

Insured persons: Please state names and dates of birth: *

Please specify details / add additional information.

Privacy statement: *

I have read the data privacy statement and I accept it. I also accept that the legally binding version of insurance plans offered by Insurance-Austria will always be in German.

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