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Health Declaration Form

(Kindly fill out all the information needed and do not leave any box unmarked. Passengers are required to complete a Health Declaration Form.)

* - Required to fill-up.

1. Personal Information
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2. Philippine Residence

2.1 Permanent Address


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2.2 Current Address

Same as Permanent address
(Address of Destination)
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3. Address Outside the Philippines (for Overseas Filipino Workers and Individuals with Residence Outside the Philippines)
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4. Travel History
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5. Travel Details to Davao City
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6. Exposure History

7. Clinical Information

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Upload either a Government issued ID, or school ID, or birth certificate (front side only, max file size 10MB, allowed extensions: *.jpg, *.png) *
Upload your Boarding Pass (max file size 10MB, allowed extensions: *.jpg, *.png)*
Do you have an RTPCR Result? (max file size 10MB, allowed extensions: *.jpg, *.png)*

* I hereby authorized the City Government of Davao, to collect and process the above information for the purpose of effecting control of the COVID-19 infection. I understand that my personal information is protected by RA 10173, Data Privacy Act of 2012 and that I am required by RA 11449, Bayanihan to Heal as One Act, to provide TRUTHFUL information.


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