Demographic Information

First Name

e.g John

Middle Name

Last Name

e.g me@home.com

Confirm Email

e.g me@home.com

ID Type

ID Number

Date of Birth

MM/DD/YYYY

Gender

Male

Female

Permanent address (non-nationals) /Address abroad (nationals)

House/Apt. #

Apt/Street/Building# max length(50 characters)

Street Number

State

max length(50 characters)

Zipcode

Country

Local Address (in Dominica)

Hotel/Apt/Street/Building# - Max length (50 characters)

Village

Phone Number

Occupation

e.g UN Embassador max length (50 characters)

Nationality

Flight/Route Information

Travel Method

Air

Sea

Date of Arrival

Time of Arrival

Flight/Vessel No.

Place of Embarkation

Date of Embarkation

COVID-19 Status Assessment Questions

1. Have you been diagnosed with COVID-19 within the last three(3) months?

Yes

1a. If yes to question #1, please provide a date of your illness.

1b. If yes to question #1, please upload a valid medical report.

only file types of .pdf,.png,.jpg,.jpeg allowed

2. Have you received any COVID-19 vaccine?

Yes

2a. If yes to question #2, please provide the date the vaccine was received.

2b. If yes to question #2, please upload proof.

only file types of .pdf,.png,.jpg,.jpeg allowed

Safe in Nature Booking

If you are not vaccinated, please upload your SIN Booking.

Children under Eighteen (18) years of age need to upload image of passport opened to the page with Biometric information or Picture ID

Children will be given the status of their accompanying parent

Please provide the name of the Safe in Nature accomodation

Upload SIN Booking.

only file types of .pdf,.png,.jpg,.jpeg allowed

3. Have you been in contact with someone who was diagnosed with COVID-19 within the last 5 days?

Yes

4 Do you have any of the folowing symptoms(Click all that applies)

Fever of Chills

Fever(mild) and Cough

Shortness of Breath

Extreme Fatigue

New Loss of Taste or Smell

Diarrhea

PCR Test

1. Have you taken PCR, or Rapid PCR, or any type of molecular test for COVID-19?

Yes

2. The date, swab was taken

3. Upload test results

only file types of .pdf,.png,.jpg,.jpeg allowed

Rapid Antigen Test

Citizens from the US are to provide a Rapid Antigen test

The date, swab of Antigen Test was taken (US Citizens only)

Upload Antigen test results (US Citizens Only)

only file types of .pdf,.png,.jpg,.jpeg allowed

Payment Options

Please note that you can now make payments online for COVID-19 related expenses such as your Antigen Test on arrival if necessary.
Navigate to Government of Dominica ePayment Application and select the fee you wish to pay.

Once payment is made,upload receipt as proof of payment

Antigen Test Pre Payment

only file types of .pdf,.png,.jpg,.jpeg allowed

Terms and Conditions

By completing and submitting this questionnaire, you are agreeing to comply with and be bound by the following terms and conditions -
All travelers are required –

All travelers are required –
1. to sanitize their hands at sanitization stations as directed;
2. to undergo a health assessment to include a temperature check;
3. to undertake a Rapid Diagnostic Test.
4. to wear mask at all times.

TESTING:

A rapid antigen test will be administered to all unvaccinated travellers on arrival.

If Antigen Test is positive, and traveller is symptomatic, the traveller will be admitted to Covid Care Complex (CCC).
If Antigen Test is positive, and traveller is asymptomatic, an authorized health care provider shall place a red band on the wrist of the traveller and the traveller must be isolated at home or a certified Safe in Nature property for a minimum period of 10 days at the travellers expense
If Antigen Test is negative, traveller will be deemed medically cleared at the discretion of medical officials
Travellers shall proceed to Immigration for processing and to Customs for screening.
There shall be no mandatory quarantine for fully vaccinated travellers who have been medically cleared.
Travellers who are positive and asymptomatic shall utilize certified transportation home.
Travellers who are positive and asymptomatic shall self-monitor, record temperature daily, and report any symptoms to health professionals.
Travellers who are positive and asymptomatic and are utilizing paid accommodation shall only book at Safe in Nature certified properties.

VACCINATED TRAVELLERS WITHOUT A VALID PCR RESULT:

A rapid antigen will be administered on arrival.

If the result of the Rapid Antigen Test is positive, and the traveller is symptomatic, the traveller will be admitted to Covid Care Complex (CCC) until released by an authorized Health Professional. Hospital fees will apply.
If the result of the Rapid Antigen Test is positive, and the traveller is asymptomatic, an authorized health care provider shall place a red band on the wrist of the traveller and the traveller must be isolated at home or a a certified Safe in Nature property for a minimum period of 10 days at the traveller’s expense.
The wrist band will be removed on day 11 by an authorized medical official and the traveller will be deemed medically cleared at the discretion of medical official
If the result of the Antigen test is negative, traveller will be transported to mandatory quarantine at a Safe in Nature-certified private property and an Antigen test will be repeated on day 3.
1. If test is negative, the traveller will be medically cleared at the discretion of medical officials.
2. If test result is positive, the traveller will be isolated according to (i) or (ii) above.

All costs incurred during the period of quarantine/treatment including PCR test must be paid prior to discharge.

Penalties will be applied for giving false information in the questionnaire and disregarding the quarantine process.

Submit Questionaire

TESTING:

VACCINATED TRAVELLERS WITHOUT A VALID PCR RESULT:

Staff

Bob Nilson

Nick Larson

Deon Hubert

Ella Wong

Customers

Lara Kunis

Ernie Kyllonen

Lisa Stone

Deon Portalatin

Irina Savikova

Maria Gomez

General

System

General Settings

System Settings