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Tippecanoe County Health Department Nursing TH Street Lafayette Indiana 47901 629 North 6 Phone: (765) 4239767 Fax: (765) 4239797 PreTravel Questionnaire Form (Please Print Clearly) This form is to
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How to fill out travel questionnaire form

How to fill out a travel questionnaire form:
01
Begin by carefully reading each question on the form to ensure you understand what information is being requested.
02
Gather all necessary documents and information beforehand, such as passport details, travel itinerary, medical history, and emergency contact information.
03
Fill in personal details accurately, including full name, date of birth, nationality, and contact information.
04
Provide details regarding your travel plans, such as destination, duration of stay, purpose of travel, and accommodation arrangements.
05
Answer any health-related questions honestly and provide information about any pre-existing medical conditions or medications you may be taking.
06
If required, provide details about your travel insurance coverage or any additional security measures you have in place.
07
Review your answers before submitting the form to ensure accuracy and completeness.
08
Sign and date the form as required.
09
Keep a copy of the completed form for your records.
Who needs a travel questionnaire form:
01
Individuals planning to travel abroad or to certain destinations where a travel questionnaire is mandatory.
02
Airlines, airlines' staff, and immigration authorities who require accurate information for travel purposes.
03
Travel agencies or tour operators who may need to gather necessary data about their customers for itinerary planning, safety measures, or emergency contact purposes.
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What is travel questionnaire form?
A travel questionnaire form is a document used to collect information about an individual's travel history, health status, and potential exposure to infectious diseases.
Who is required to file travel questionnaire form?
Individuals traveling to certain destinations or returning from specific locations may be required to file a travel questionnaire form as mandated by health authorities or government regulations.
How to fill out travel questionnaire form?
To fill out a travel questionnaire form, individuals typically need to provide personal information, details about their travel itinerary, any symptoms they may be experiencing, and any relevant health history.
What is the purpose of travel questionnaire form?
The purpose of a travel questionnaire form is to assess health risks related to travel, facilitate contact tracing, and ensure appropriate health measures are taken to prevent the spread of diseases.
What information must be reported on travel questionnaire form?
The information that must be reported on a travel questionnaire form generally includes personal information, travel dates, destinations, details of accommodations, health symptoms, vaccination status, and exposure to others who may be ill.
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