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Valid Sanitation Control Exemption/Control Certificate carried on board? YES NO Issued at : Date: Name of ship Master s name No of crew Re inspection required? YES NO Has ship visited an affected area identified by the World Health Organization? YES NO Port and date of visit Health Questions YES 1 2 3 4 5 6 7.

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How to fill out the Maritime Health Declaration Form online

Filling out the Maritime Health Declaration Form online is a crucial step in ensuring the health and safety of all individuals on board. This guide provides clear instructions for completing each section of the form accurately and efficiently.

Follow the steps to successfully complete the Maritime Health Declaration Form.

  1. Click ‘Get Form’ button to access the Maritime Health Declaration Form in your editing interface.
  2. Begin by entering the IMO number and estimated time of arrival (ETA) as required. This information is vital for identifying your vessel.
  3. Record the number of passengers and specify the next and last ports of call, ensuring all details are accurate.
  4. Indicate whether a valid sanitation control exemption or control certificate is carried on board by selecting 'YES' or 'NO'. Provide the issuing details including the date.
  5. Fill in the name of the ship, the master's name, and the crew count. Ensure this information is up-to-date for compliance.
  6. Answer the question about re-inspection requirements by selecting 'YES' or 'NO'. This may affect your vessel's port entry.
  7. Address the health inquiries by indicating if the ship has visited an affected area as per World Health Organization guidelines.
  8. Complete the health questions section, indicating 'YES' or 'NO' to any relevant medical situations on board. Provide details for any affirmative responses.
  9. Declare any deaths on board during the voyage and provide the total number if applicable. Include specifics for any illnesses that may have arisen and medical assistance received.
  10. Finalize the declaration by signing and dating the form, confirming that all information provided is true to the best of your knowledge.
  11. Once all sections are filled, save your changes, and ensure you can download, print, or share the document as required.

Complete your Maritime Health Declaration Form online today to ensure a safe and smooth journey.

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When arriving from a foreign port, a Master of a ship is required to report to the Port Health Authority any suspected infectious disease or death on board amongst crew, passengers or any animals or birds. This report should be made not less than 4 hours and not more than 12 hours before arrival.

A Maritime Declaration of Health is the form used to provide such information. It covers: details of the ship. status of any Ship Sanitation Certification. number of passengers.

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