Public Health Questionnaire
Date: __________ Ship: _________________ Stateroom #___________
NAME: __________________________________________________________________________ Travel History
Names of children under age 18 travelling with you:
1. ______________________________________ 2.______________________________________
1. Have you visited OR transited through Mainland CHINA, HONG KONG, MACAU, SOUTH
3._______________________________________ 4.______________________________________
KOREA, IRAN, SINGAPORE, JAPAN, TAIWAN or an EU Schengen Country in the past 21
days?
To assist in preventing the spread of Communicable Disease during your cruise, we require you to
(Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece,
answer the following questions:
Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands,
Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden and Switzerland)
1. Within the last 7 days, have you, or any person listed above, had any of the following symptoms:
Fever, Chills, Cough, Runny Nose, Sore Throat or Shortness of breath?
YES NO
If yes, please specify which country: __________________________________
YES NO
2. Within the last 2 days, have you, or any person listed above, developed any symptoms of Diarrhea
2. Have you been exposed (in contact with) to anyone Mainland CHINA, HONG KONG,
or Vomiting?
MACAU, SOUTH KOREA, IRAN, SINGAPORE, JAPAN, TAIWAN or an EU Schengen
Country in the past 21 days?
YES NO
(Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece,
Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands,
Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden and Switzerland)
3. Are you (or anyone listed above) known to suffer or are you under treatment for any chronic heart,
lung, liver or kidney disease OR are under treatment for any illness known to lower your immune
system competence (e.g. diabetes, HIV/AIDS, cancer)?
YES NO UNSURE
YES NO
4. Has anyone in your party had contact with, or helped care for, anyone suspected or diagnosed as
having COVID-19, or anyone who is currently subject to health monitoring for possible exposure
I CERTIFY that the above declarations are true and correct and that any dishonest answers may
to COVID-19?
have serious public health or medical implications.
YES NO
Signature:
(If you answered “Yes” to any question(s), you will be assessed free of charge by a member of
our shipboard medical staff. You will be permitted to travel, unless you are suspected to have
an illness of international public health concern)
PREGNANCY Notice: For your health and safety, Royal Caribbean Cruises Ltd. cannot
accept guests who will have entered their 24th week of pregnancy at any time during the
cruise or cruise tour. If this policy applies to you, or anyone in your party, do not board the
ship and immediately bring this to the attention of your cruise check-in agent.
