Vaccination Confirmation

Kindly confirm whether you are vaccinated or not applicable using the form given below

Date(Required)

Name

First Last

Country

Passport Number

Declare Vaccinated or Not Applicable(Required)

First Vaccination Date

Second Vaccination Date

First Vaccination Date
Not Applicable

Second Vaccination Date
Not Applicable

Upload vaccination card image or document or certificate if applicable

Declaration(Required)

I DECLARE THAT THE ABOVE INFORMATION IS ACCURATE TO THE BEST OF MY KNOWLEDGE.

Declaration

I AM DOUBLE VACCINATED AND UNDERSTAND THE ENTRY RESTRICTIONS IN INDONESIA FOR NON-VACCINATED TRAVELLERS

Declaration

I UNDERSTAND AND AGREE THAT ANY COSTS AND EXPENSES ARISING OUT OF QUARANTINE OR RESTRICTIONS FOR NON-VACCINATED TRAVELLERS WILL BE SOLELY MY RESPONSIBILITY

Declaration

I AM UNDER 18 YEARS OF AGE AND INDONESIA DOES NOT REQUIRE ME TO BE VACCINATED FOR ENTRY INTO THE COUNTRY

Declaration(Required)

I HAVE REQUIRED TRAVEL INSURANCE INCLUDING COVID-RELATED COVER

My Account

Vaccination Confirmation