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Entry health declaration

Entry health declaration

THIS IS IMPORTANT DOCUMENT, YOUR INFORMATION IS VITAL TO ALLOW HEALTH AUTHORITIES CONTACT YOU TO PREVENT COMMUNICABLE DISEASES

Warning: Declaring false information is a violation of Vietnamese law and can be criminally handled

Subject*

Enter your subject

Port of Entry*

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Travel information *

Place of departure (Province/ Country) *

Country/ Region*

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Place of destination *

Country/ Region*

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Choose a quarantine facility *

Select a property after quarantine *

City*

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Disctrict*

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Ward*

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Contact information in VietNam *

City*

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Disctrict*

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Ward*

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In the past 14 days, which province / city / territory / country have you been to? *

If you have any of the followings at present or during the past 14 days (until the date of entry/exit/transit)?

Yes
No
Fever
Cough
Difficulty of breathing
Some Throat
Vomitting
Diarrhea
Rash
Skin haemorrhage

History of exposure: During the last 14 days, did you

Yes
No
Visit any poultry farm / living animal market / slaughter house / contact to animal
Care for a sick person of communicables diseases

The data you provide is kept completely confidential and only will serve pandemic prevention and control purposes, under the management of the National Steering Committee for COVID-19 Prevention and Control. Pressing the "Submit" button means you understand and agree.