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  • If you have already filled up this form and generated a bar code but want to correct some information in your detail then do not fill the form again but rather go to Correction Support for further assistance.
  • For Flight traveller, fill the form after flight ticket is confirmed and PCR report is collected.

1. Personal Details

2. Family Details

3. Travel History (Past 30 Days)

From To Mode of Travel Flight/Vehicle No. Date Action

4. Current Resident Country

5. Quarantine Details

Quarantine Hotel List ?

6. Health Information

Self-Declaration

  • The above information is correct and I am subject to legal consequences if found otherwise.
  • I will abide by the health directives issued by Government of Nepal during my stay in Quarantine.
  • I will take utmost care to abide by the health directives of Government of Nepal to contain the possible spread of COVID 19 from me to my community.
  • If I have chosen Hotel Quarantine, I am willing to pay for all my expenses during my stay there.