Cruise Dialysis

Celebrity Silhouette Sailing from Southampton Booking Form

Please complete the form below. Once you have done so please click on the submit button at the end. We will then forward your booking information to you.

If you would like to book for more than 2 passengers or have any questions please contact us on 0844 995 1214.

Celebrity Silhouette Booking Form
Cruise Line *
Cruise *
Have all passengers been fully vaccinated for Covid19, including booster? *
Are any passengers taking a wheelchair or mobility scooter onboard? *
Will a dialysis patient be occupying this cabin? If yes, please put the dialysis patient's details in the boxes for PASSENGER 1 below *
Is Passenger 1 a dialysis patient? *
Is Passenger 2 a dialysis patient? *
Does the patient currently test negative for Hepatitis B, Hepatitis C, HIV and MRSA? *
Dialysis Time Required - Subject to Availability (please choose two options)
Do you require the Celebrity Always Included Fare or the No Perks Fare?
Would you like a double bed or twin beds?
Evening Dining Time
What sized table would you like for your evening meal?
Do any of the guests have any of the following dietary requirements? *
Do any of the passengers have any sensory impairments? *
Do any of the passengers require supplementary oxygen? *
I have read the email sent to me and understand the cost of the dialysis during my cruise *
I have read the email sent to me and understand the cost of the service charge for my cruise *