Support for Travellers Form - Print

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Help

support-for-travellers

First name (primary contact)Missing or incorrect value

Last name (primary contact)Missing or incorrect value

Date of birth (yyyy/mm/dd)Missing or incorrect value

Phone numberMissing or incorrect value

Email (optional)

Home addressMissing or incorrect value

CityMissing or incorrect value

Postal CodeMissing or incorrect value

Are there additional travellers in your group?

Number of additional travellers in your group?

For each traveller, please list their last name, first name and date of birth

First Name

Last Name

Date of birth (yyyy/mm/dd)

Arrival Date (yyyy/mm/dd)Missing or incorrect value

Arrival ByMissing or incorrect value

Airline / Flight Number (if applicable)

Arrival From (City, Country)Missing or incorrect value

Your personal information as well as those of your household is collected by the Ministry of Health under the authority of sections 26(a), (c), (e) and s.27(1)(a)(iii) of the Freedom of Information and Protection of Privacy Act, the Public Health Act and the federal Quarantine Act, for the purposes of reducing the spread of COVID-19. Personal information may be shared with personnel providing support services and follow-up during self-isolation. Should you have any questions or concerns about the collection of your personal information please contact:

Title: Ministry of Health, Chief Privacy Officer
Telephone: 236-478-1666

HLTH 8100