eOS-COVID - Form

Personal information

Last name
First name
Birthdate
Country of birth
Zipcode of birth
Birthplace
Gender
Are you a healthcare professional ?

Contact details

Dialling code
Phone number
E-mail
What type of accommodation will you be staying in ?
Number and street name
Country
Zipcode
City

Health

Social security number
Have you been vaccinated against COVID-19 ?


Instructions :

  • 7 days after second dose (Pfizer, Moderna, AstraZeneca) : type YES
  • 7 days after first dose and you previously had COVID-19 (Pfizer, Moderna, AstraZeneca) : type YES
  • 28 days after single-dose (Johnson & Johnson) : type YES
  • For every other situation (other vaccine, didn't have your second dose, not enough time since your last dose, etc) : type NO

Informations about border health checks and about recognized vaccine pattern can be found on https://www.gouvernement.fr/info-coronavirus/deplacements


Do you have any symptoms of COVID-19 ?