Entry health declaration

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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*

Select...

Travel information *

Plane

Car

Ship

Other

Vehicle No. *

Seat No. (if any)

Departure date *

Entry date *

Place of departure (Province/ Country) *

Country/ Region*

Select...

City *

Place of destination *

Country/ Region*

Select...

City *

Choose a quarantine facility *

General isolation base set

Self-selected quarantine facility

Other

Select a property after quarantine *

City*

Select...

Disctrict*

Select...

Ward*

Select...

Address *

Contact information in VietNam *

City*

Select...

Disctrict*

Select...

Ward*

Select...

Address *

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

Yes

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

Yes

Fever

Cough

Difficulty of breathing

Some Throat

Vomitting

Diarrhea

Rash

Skin haemorrhage

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

Yes

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.