Health Declaration Form- Covid-19 - Harbour Air Seaplanes

First Name *

Last Name *

Flight Date *

Departure Location *

1 - Do you have a fever, a cough, or breathing difficulty? *

NoYesNo

2 - Do you have, or suspect you have, COVID-19? *

NoYesNo

3 - Have you been refused boarding in the past 10 days due to a medical reason related to COVID-19? *

NoYesNo

4 - Are you currently under mandatory quarantine, as a result of recent travel or by orders from the provincial, territorial or local public health authorities? *

NoYesNo

5 - Do you have a removable mask or face covering with which to cover your mouth and nose while aboard the aircraft, for the full duration of the flight? *

NoYesNo

I understand non-compliance, and/or providing a false or misleading answer on this Health Declaration could result in a maximum fine of $5,000 issued by Transport Canada.

I agree to notify Harbour Air by email at reservation@harbourair.com of any change in status, including diagnosis with COVID-19 and/or requirement to quarantine five (5) days before, or within five (5) days following a Harbour Air flight. If required, I consent to my contact information to be provided to the Provincial Health Officer to assist in trace tracking.

I will wear a mask over my nose and mouth at all times aboard the aircraft.

In signing below, I am an individual over the age of 18 of sound mind, knowingly, voluntarily, and freely agree to the terms of this binding Declaration.

I certify the information above is complete and accurate. I acknowledge that the information on this form will be kept securely stored and encrypted on Colib website, viewable by the organization I plan to visit.

Signature :

Health Declaration Form- Covid-19 - Harbour Air Seaplanes

Thank you for completing the form.

The information has been received.

Important Notice:

Based on your answers, Transport Canada has deemed it necessary you meet additional conditions to be eligible for travel. Without meeting these conditions, you may not be able to travel.

Let's view your own form now