COVID-19 InformationU.S. Embassy & Consulates in Japan 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal information, including your name, date of birth, address, phone number, and email. Ensure all details are accurate for effective communication.
3. In the travel itinerary section, list the countries you plan to visit along with the cities and towns. Specify your length of stay and type of accommodations for each location.
4. Proceed to the health history section. Answer questions regarding allergies, pregnancy status, immune disorders, and any chronic diseases. Provide detailed responses where necessary.
5. List all medications you are currently taking in the designated area. Include both prescription and over-the-counter medications for a comprehensive overview.
6. Review the travel clinic waiver carefully before signing. Ensure you understand payment responsibilities and cancellation policies.
7. Once completed, save your form and submit it via email or fax as instructed at least one week prior to your appointment.

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