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Covid-19 | Health Status before Departure Crew Member

Purpose of this template: information to be recorded by the crew prior to departure to confirm their COVID-19 health status and to facilitate processing by government health authorities. Notwithstanding the completion of this card, a crew member may be subject to additional examination by the health authorities as part of a multi-layered preventive approach, e.g. if the recorded temperature is 38°C or higher.
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Covid-19 | Health Status before Departure Crew Member

CREW COVID-19 HEALTH STATUS

In the past 14 days, have you had close contact (face to face within one meter and for more than 15 minutes or direct physical contact) with anyone who had symptoms suggestive of COVID-19?

Have you had any of the following symptoms in the last 14 days?

Temperature at start of work

Temperature is not recorded because the person does not feel/appear feverish

Temperature in degrees Celsius

Datum & Uhrzeit

Recording method

Haben Sie in den letzten 14 Tagen einen positiven COVID-19-Test erhalten?

Crew member Identification

Name:

Airline / aircraft operator:

Nationality and Passport No:

Signature:

Datum & Uhrzeit:

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