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Camiguin Health Declaration Form

(Kindly fill out all the information needed and do not leave any box unmarked. Travelers are required to complete a Health Declaration Form.)

* - Required to fill-up.

Personal Information
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Destination Address
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Travel Details to Province of Camiguin

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Exposure History

Clinical Information

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Upload the Coordination Letter for Tourist (max file size 10MB, allowed extensions: *.jpg, *.png, *.pdf)*
Upload your Confirmed Booking, Invitation, or Confirmation of Stay (max file size 10MB, allowed extensions: *.jpg, *.png, *.pdf)*
Upload your RTPCR Result. (max file size 10MB, allowed extensions: *.jpg, *.png, *.pdf)*
Upload your Vaccination ID/Card picture. (max file size 10MB, allowed extensions: *.jpg, *.png, *.pdf)*

* I hereby authorized the Province of Camiguin, to collect and process the above information for the purpose of effecting control of the COVID-19 infection. I understand that my personal information is protected by RA 10173, Data Privacy Act of 2012 and that I am required by RA 11449, Bayanihan to Heal as One Act, to provide TRUTHFUL information.


Camiguin Health Declaration Form
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