Please complete the form

Terms and Conditions: All passengers must provide accurate information, in accordance with the 2005 WHO International Health Regulations. The information you share in this application is confidential, it will be used by the Ministry of Health and the airport authorities, to contact you if a positive case is identified on the flight on which you arrived.

A. Flight information:

B. Passenger Information:



(If your response is No please complete C. section )

D. Trip control data:

Enter the destinations you have been to in the last 14 days, country/city/date

E. Health History:

Have you been in contact with a confirmed case of the CoVID-19?

Date you were in contact

Someone traveling with you had contact with a confirmed case of COVID-19

Date were in contact with the case

F. Symptom assessment

Have you had any of these symptoms during the 7 days prior to the date of your trip to Guatemala

Fever 38C

Cough

   

Sore throat

   

Loss of taste

   

Loss of smell

   

Diarrhea

   

Headache

   

Difficulty Breathing

   

G. COVID19 PCR test

Did you performed a COVID test and have a certificate?

   

The test was conducted within 72 hours prior to your trip to Guatemala

   

Type of test performed for COVID19

The test result was?

   

If during your trip you have symptoms or the authority requires it, you will be tested at the Airport / Terminal / Port Health Service.

   

I declare that the data entered in this form are true