Combined passenger disclosure and attestation to the united states of america


Proof of Being Fully Vaccinated Against COVID-19



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CDC Attestation

Proof of Being Fully Vaccinated Against COVID-19
and has made or has had the 
following arrangements made on their behalf (
must check all boxes in F and then proceed to sign Attestation
).
To be tested with a COVID-19 viral test 3-5 days after arriving in the United States, unless this person has 
documentation of having recovered from COVID-19 in the past 90 days;
To self-quarantine for a full 7 calendar days, even if the test result to this person’s post-arrival viral test is 
negative, unless this person has documentation of having recovered from COVID-19 in the past 90.
To self-isolate if the result of the post-arrival viral test is positive or if this person develops COVID-19 symptoms.
To become fully vaccinated against COVID-19 within 60 days of arriving in the United States, or as soon 
thereafter as is medically appropriate, if intending to stay in the United States for more than 60 days.

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