Online Health Certificate

Contact Info

Your Name

Enter your name, as shown in your current passport or travel document. Your given name is usually your first name. Your family name is the surname that is shared by your family. If you have middle names, include these with your given name. If your name has a suffix (e.g. Jr), include this with your given name. If you have a patronymic name include it with your given names. You must tell us all your given names.

Given name(s)

Family name

Your Sex

What is your sex

Male

Female

Prefer not to say

Your date of birth

When do you plan to arrive in the UK?

For example, 24 6 2020

Contact Information

Email address

Your telephone number

Provide your primary and secondary telephone numbers

Only include numbers for both the country code and the rest of your telephone number.

Provide your secondary telephone number

Contacting you by telephone

Are you able to be contacted by telephone?

I can be contacted by telephone call and text message (SMS)

I can only be contacted by telephone call

I can only be contacted by text message (SMS)

I cannot be contacted by telephone call or text message (SMS)