• Use Google Chrome or Mozilla Firefox for browsing the form.
  • For any feedback or correction on Form, please go to Correction Support and enter your email, passport number and other details.
  • Fields in red color are mandatory. So only after submitting mandatory and correct detail, an email is automatically sent with other information.
  • After submitting the form, a System Generated Bar Code is displayed, please take a screenshot (Win + PrtSc) or print it and keep it safely. The form will be downloaded automatically in your device
  • 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.
  • This form is prepared for the details of Passenger Locator and Health Declaration of the passengers.

1. Personal Details

2. Travel History (Past 30 Days)

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

3. Country of Current Residence

4. Quarantine Details

Quarantine Hotel List ?

5. 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 the Government of Nepal during my stay in Quarantine.
  • I will take utmost care to abide by the health directives of the 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.