Health Declaration Form for travelers entering Bonaire

To protect your health and the health of the general public of Bonaire, you are required by the public health department of Bonaire to complete this form. 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. It is important to fill out this form completely and accurately. Your information is intended to be held in accordance with applicable laws and is used for public health purposes only. Thank you for your assistance to protect your health and the health of the general public of Bonaire.
One form should be completed by each person. Parents should complete this form for minors.

Please note!

As per April 20th the completed health declaration form will be the only requirement to enter Bonaire.

The travel requirements can be found on:

Please complete this form between 24 and 12 hours before your departure to Bonaire.

Please print this form after completion and keep it in your hand luggage. You may be asked to show this during your journey by a public health officer.

Arrival date on Bonaire
Bonaire Resident
Departure date leaving Bonaire

Do you have any of the following symptoms at this moment?
Please check the box if the answer is yes

Have you been in contact with a confirmed case of COVID-19 in the past 14 days?

In which countries, or on which island, have you stayed during the past 14 days?
You are obliged to mention here all the countries or islands where you have been during the past 14 days. (Multiple answers are possible by pressing +)

Did you do a COVID-19 PCR test or antigen test within the required time frame?

If you did a test, what was the result?

Have you had corona in the past 6 months (180 days)?

Have you been vaccinated?

If so, with which vaccine?

And on what date/dates were you vaccinated?

Take your proof of vaccination with you when traveling.

Please follow up the instructions in the confirmation email that you will receive.

I am a parent/guardian and completed this form on behalf of a minor: