• Country Entry Health and Travel Questionnaire

    Please complete this form to provide your health and travel information as required for country entry screening.
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Have you experienced any of the following symptoms in the past 14 days?*
  • Have you been in close contact with anyone diagnosed with an infectious disease (e.g., COVID-19, influenza) in the last 14 days?*
  • Have you received any vaccinations in the past 12 months?*
  • Purpose of Travel*
  • Should be Empty:
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