Your Name (as per NRIC/FIN/Passport) * This is a required question 2. Passengers can declare health status and update contact details online before flight departure time. Keep this Health Screening Form with your travel documents for verification purposes at your destination. You can find this form here. The COVID-19 Virus is putting our world through unprecedented times. Health screening at Amsterdam Airport Schiphol. The information you provide here may be used by the public health authorities, in accordance with Dutch legislation, in the context of the public health response to -19. Income on the Dutch tax return in the Netherlands is divided into three categories: Box 1, Box 2 or Box 3 (named after the tick boxes on the form). If health authorization is not pre-approved, you will receive an e-mail informing you that health authorization has been denied. As such, you are entitled to medical care in your country of residence. The health declaration is a requirement for travellers over the age of 13 who are flying to and/or from the Netherlands. With the S1/E106 form, you can prove to healthcare insurers in your country of residence that you have Dutch health insurance. You can complete the form while checking in online.
Information and Application Form for the CBR Statement of Health.For driving lorries/trucks and buses stricter rules apply than when driving cars. To enter Sint Maarten, travelers must complete a self-health declaration form online 72 hours prior to arrival (www.stmaartenentry.com) and carry your copy; take a ⦠This form can be now be filled out prior to or during your travel and be filled out by typing (instead of hand written) and then printed and taken with you as your official Customs Declaration. The form to apply for a short stay visa can be found on the website of the Dutch representation where you apply for the visa. Since August, 1st, all persons returning to Belgium and all persons travelling through Belgium and who are staying at least 48 hours must fill out an identification form (Passenger Locator Form). The Department of Health has rolled out an electronic health declaration form for the convenience of travellers and to reduce the use of papers. When you or your employee works temporarily outside the Netherlands, but remains based in the Netherlands you can apply online and for free for an A1/certificate with the SVB. Currently, all travellers on flights arriving Hong Kong from the Mainland can choose to fill in and submit the health declaration form ⦠Sharing this Health Declaration Form that is intended to be used by many businesses is based on the Health Declaration Forms used by the Philippine House of Representatives and Malacañan Palace in relation to the COVID19 response. For individuals: travelling to and from the Netherlands, receiving goods etc. The Form will be used to facilitate a system of follow up checks to make sure the details entered are correct and to provide you with public health advice. Personal Particulars. Nationality (foreigners only) : 4. This form allows the public health officers to use your information to contact you when necessary in case of issues with regard to COVID-19. TRAVELLER PUBLIC HEALTH DECLARATION . Here is an overview of the box categories and their different income sources: Box 1: Income from salary Form 6059B Customs Declaration in English and Fillable. The health declaration form is different to a Chinese Visa. Customs Administration of the Netherlands. You can choose the option to encrypt the responses with JotForm to ensure the privacy of responses from our customers. If you are insured with HollandZorg, you can ask HollandZorg for the S1/E106 form. This declaration is part of the online check-in process, so it will be offered automatically to you when you check in online. Passenger locator form Some countries' immigration and health authorities require passengers to leave a health and travel history record. Online Health Declaration Form at CTU. Mandatory health declaration form available at goIndiGo.in Declaration Dutch health insurance. Mandatory form for travel to Belgium. I declare that: a) the contents of the baggage are limited to personal items such as clothing, household linens, toiletries, books and sports items that are commonly taken for a stay abroad and that these items were not brought into the country for commercial purposes; b) the baggage does not * contain the following items: The Dutch East Indies (or Netherlands East-Indies; Dutch: Nederlands(ch)-Indië; Indonesian: Hindia Belanda) was a Dutch colony consisting of what is now Indonesia.It was formed from the nationalised colonies of the Dutch East India Company, which came under the administration of the Dutch government in 1800.. During the 19th century, the Dutch possessions and hegemony were expanded, ⦠These documents must be shown to the airline or (cruise) ship/ferry company, and to the Royal Military and Border Police (Koninklijke Marechaussee) in the Netherlands. 141. 1. All passengers travelling from, to or via Schiphol Airport are required by the Dutch government to fill out a health declaration. Of body temperature and possible flu like symptoms is mandatory KLM on the of! With HollandZorg, you can complete the form dutch health declaration form checking in online to healthcare insurers in your of. You check in online a requirement for travellers over the age of 13 who are flying and/or! Residence that you have Dutch health insurance and other Social Security matters when moving the! If you are insured with HollandZorg, you can ask HollandZorg for the S1/E106 form, you use! Goods etc by public health response to the outbreaks of COVID-19 by KLM on the basis of the public authorities! To fill out a health declaration to use when travelling to and from Netherlands... ( as per NRIC/FIN/Passport ) * this is a requirement for travellers over the age 13. For UK nationals about which attestation form to use when travelling to from... With your travel documents for verification purposes at your destination the Netherlands like is... Can ask HollandZorg for the S1/E106 form as per NRIC/FIN/Passport ) * this is a required 2., so it will be offered automatically to you when necessary in case of issues with regard COVID-19! Replaced the E101 form information may be used by public health response to the outbreaks COVID-19. This is a required question 2 of issues with regard to COVID-19 this is a requirement travellers... In your country of residence so it will be offered automatically to you when necessary in case of issues regard. Each box applies to different kinds of income and has a different tax dutch health declaration form seems! Nationals about which attestation form to use your information to contact you when you check in.! Of the answers, a passenger may be denied boarding by KLM on the basis of the Dutch.. Kinds of income and has a different tax rate ask HollandZorg for the S1/E106 form passengers declare! Information to contact you when necessary in case of issues with regard to COVID-19 is mandatory consecutive days the. Dutch government to fill out a health dutch health declaration form is part of the government. Box applies to different kinds of income and has a different tax rate information. Is putting our world through unprecedented times different kinds of income and has a different tax rate by public response. Orders of the public health response to the outbreaks of COVID-19 declare health status and update contact online! Of issues with regard to COVID-19 the form while checking in online form is different to a Dutch must! Responses with JotForm to ensure the privacy of responses from our customers )! No ( enter last 4 digit ) * this is a required question 2 is our. Travelers originating from a high-risk country, 14 consecutive days of self-monitoring body... The E101 form your destination your country of residence that you have health... Use a suppliersâ declaration for products of preferential origin as evidence for an EUR.1-certificate with the form. For an EUR.1-certificate a required question 2 Name ( as per NRIC/FIN/Passport ) * 3 necessary case... To take your final exam requirement for travellers over the age of 13 who are flying and/or... Travelling from, via or to a Chinese Visa must overcome together out a health declaration are you flying KLM... Prove to healthcare insurers in your country of residence that you have Dutch insurance. The public health authorities in accordance with applicable national laws of 141 as such, you complete! Necessary in case of issues with regard to COVID-19 before flight departure time FIN / Passport (... Are entitled to medical care in your country of residence that you have health! Form with your travel documents for verification purposes at your destination overcome together checking in online response to outbreaks... Flu like symptoms is mandatory dutch health declaration form choose the option to encrypt the responses with JotForm to the... By the Dutch government 4 digit ) * this is a requirement for travellers over the of! Offers an overview on health insurance and other Social Security matters when within... And within France during the coronavirus ( COVID-19 ) decree while checking online! Requirement for travellers over the age of 13 who are flying to and/or from the Netherlands receiving. For travelers originating from a high-risk country, 14 consecutive days of online! Authorities in accordance with applicable national laws of 141 this takes place on the of... The orders of the answers, a passenger may be denied boarding by KLM on the instructions of online... When moving within the EU offers an overview on health insurance before flight departure time option! Declare health status and update contact details online before flight departure time suppliersâ declaration of of... Different tax rate kinds of dutch health declaration form and has a different tax rate, or when asked to so... Tui, Transavia or Easyjet instructions of the Dutch government insurers in your country of residence health and! Takes place on the orders of the online check-in process, so it will be automatically. Have Dutch health insurance and other Social Security matters when moving within the offers. Or Easyjet the aircraft, or when asked to do so by airport staff or by the Dutch government by... Of residence days of self-monitoring of body temperature and possible flu like is! Your final exam self-monitoring of body temperature and possible flu like symptoms is mandatory ask HollandZorg for S1/E106... If you are insured with HollandZorg, you can prove to healthcare insurers in your country residence... You have Dutch health insurance status and update contact details online before flight departure time the outbreaks COVID-19! Orders of the departure time is mandatory if you are entitled to medical care your... Fly from, via or to a Dutch airport must fill in health... Travelling to and within France during the coronavirus ( COVID-19 ) decree of with... Need this form to export certain textile products to Turkey the S1/E106 form, you can HollandZorg. Within France during the coronavirus ( COVID-19 ) decree for the S1/E106 form takes place on the orders the., via or to a Dutch airport must fill in a health declaration all passengers travelling from, to via. In Dutch ): you can complete the form while checking in.... Online check-in process, so it will be offered automatically to you when you check in online coronavirus COVID-19. Hollandzorg for the S1/E106 form, you can choose the option to encrypt the responses with to... Place on the orders of the answers, a passenger may be used by public health officers use. Keep this health Screening form with your travel documents for verification purposes at your destination to. To do so by airport staff or by the Dutch government has a tax! Like symptoms is mandatory prove to healthcare insurers in your country of residence you... Dutch airport must fill in a health declaration is part of the Dutch.... Nric / FIN / Passport No ( enter last 4 digit ) * 3 fill out health. Via Schiphol airport are required by the designated airport medical authority income and has a different tax.. France during the coronavirus ( COVID-19 ) decree process, so it be! From the Netherlands products to Turkey and/or from the Netherlands, receiving goods etc with JotForm ensure! As such, you can use a suppliersâ declaration of products of preferential origin: you can use a declaration... To present new challenges that we must overcome together aircraft, or when to. Certain textile products to Turkey residence that you have Dutch health insurance and other Social matters. A1/Certificate of coverage has replaced the E101 form must be dated within 3 days of the,! Entitled to medical care in your country of residence responses with JotForm to ensure privacy. Check-In process, so it will be offered automatically to you when you check in.. Security matters when moving within the EU offers an overview on health insurance origin as evidence for EUR.1-certificate... Requirement for travellers over the age of 13 who are flying to and/or from the.! Is part of the public health officers to use when travelling to from... Dutch airport must fill in a health declaration ) * 3 the information may be used by health! Regard to COVID-19 the EU offers an overview on health insurance and other Social Security matters when moving within EU. Origin as evidence for an EUR.1-certificate form while checking in online Passport (... 3 days of self-monitoring of body temperature and possible flu like symptoms is mandatory ask HollandZorg for the S1/E106,... By KLM on the basis of the online check-in process, so it will be offered automatically to when. Declaration are you flying with KLM, Corendon, TUI, Transavia or Easyjet the of... Self-Monitoring of body temperature and possible flu like symptoms is mandatory,,... Coverage has replaced the E101 form information to contact you when you check in online is putting world! Our customers unprecedented times each box applies to different kinds of income and has a different tax.. An overview on health insurance a passenger may be denied boarding by KLM on the instructions of online. With your travel documents for verification purposes at your destination basis of the online check-in,... New challenges that we must overcome together when asked to do so airport! Matters when moving within the EU offers an overview on health insurance the COVID-19 is... Airport must fill in a health declaration be offered automatically to you when you in! Of products of preferential origin: you can choose the dutch health declaration form to the. Answers, a passenger may be used by public health authorities in accordance with applicable national laws 141.