Free Airline Passenger Health Form Template
Airline Passenger Health Form
Please fill out this form completely to ensure your health and safety during your flight.
Name
Passport Number
Phone number
Health Status
Do you have any of the following symptoms?
Select all that apply.
-
Fever
-
Cough
-
Shortness of breath
-
Fatigue
-
Have you been in close contact with anyone diagnosed with a contagious disease?
Travel Information
Have you traveled outside your home country in the last 14 days?
Countries visited (if applicable)
Emergency Contact
Name
Phone number
Declaration
I confirm that the information provided is accurate and complete to the best of my knowledge.
Name:
Date:
Thank you for your submission!
We appreciate you taking the time to submit.
Create free forms at Template.net
