The Quarantine Declaration Form is a crucial document implemented under Indonesian health and immigration regulations, particularly Law No. 6 of 2018 on Health Quarantine. This form became especially significant during global health emergencies, serving as a primary tool for health screening and contact tracing. It requires individuals to declare their health status, recent travel history, and potential exposure to infectious diseases. The document plays a vital role in Indonesia's public health surveillance system, helping authorities monitor and control the spread of communicable diseases at points of entry and within the country. The form must be completed truthfully, with legal consequences for false declarations, and typically accompanies other travel and immigration documentation required by Indonesian authorities.
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1. Personal Information: Essential details including full name, passport number, nationality, date of birth, and contact information
2. Travel History: Details of travel in the past 14 days, including countries visited and transit points
3. Current Health Status: Declaration of current health conditions, symptoms, and any existing medical conditions
4. Contact History: Information about potential contact with confirmed cases of infectious diseases
5. Quarantine Location Details: Information about where the individual will quarantine, including complete address and contact details
6. Legal Declaration: Statement confirming the truth of provided information and understanding of legal consequences for false declarations
7. Signature and Date: Space for declarant's signature, date, and place of signing
1. Vaccination Status: Details of COVID-19 or other relevant vaccinations - optional based on current health regulations
2. Medical Test Results: Section for recording recent COVID-19 or other medical test results - included when specific testing is required
3. Emergency Contact: Details of emergency contact person in Indonesia - required for foreign nationals but optional for citizens
4. Special Assistance Requirements: Section for declaring any special needs during quarantine period - included when applicable
1. Health Symptoms Checklist: Detailed checklist of relevant health symptoms to be marked by the declarant
2. Information Sheet: Summary of current quarantine regulations and requirements in Indonesia
3. Contact Monitoring Form: Form for daily temperature and symptom monitoring during quarantine period
4. Local Health Authority Contacts: List of emergency numbers and relevant health authority contacts
Relevant legal definitions
Clauses
Relevant Industries
Healthcare
Aviation
Maritime
Tourism
Hospitality
Transportation
Immigration Services
Government Services
Medical Services
Border Control
Public Health
Relevant Teams
Immigration
Port Health
Border Control
Public Health
Medical Services
Risk Management
Corporate Travel
Human Resources
Compliance
Health and Safety
Operations
Guest Services
Relevant Roles
Immigration Officer
Port Health Officer
Public Health Inspector
Quarantine Officer
Border Control Officer
Health and Safety Manager
Travel Compliance Officer
Medical Officer
Airport Manager
Seaport Manager
Hotel Manager
Human Resources Director
Risk Management Officer
Corporate Travel Manager
Health Protocol Supervisor
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