Is the form mandatory for entry?

Requirement depends on current Peruvian entry rules and carrier policies. Verify with your airline and official Peru health authority guidance before travel to confirm whether the declaration is required for your itinerary.

Can I sign electronically from the U.S.?

Yes where electronic submission is accepted. U.S. eSign legality is governed by the ESIGN Act (15 U.S.C. ch. 96) and by state UETA laws for intrastate matters; ensure the platform captures an audit trail.

Does submitting the form share my medical data broadly?

Data is used for public health purposes and may be shared with authorized agencies. Healthcare data handled in the U.S. may trigger HIPAA considerations when transmitted to providers; check privacy disclosures on the form.

What if I make a mistake after submitting?

If you can edit the submission via confirmation link, do so immediately. Otherwise notify the airline or public health authority and, if necessary, submit a corrected declaration as directed.

Can minors complete their own form?

Minors typically require a parent or guardian to complete and sign the form. Follow carrier and Peruvian authority guidance for signatures and consent for travelers under the age of majority.

How long should I keep my copy?

Retain the submitted declaration and any confirmations for at least three years for administrative records; healthcare-related information may require six years per HIPAA (45 CFR §164.530(j)).

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Peru Health Declaration Form

Peru Health Declaration Form

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Apus Peru Adventure Travel Specialists Medical Declaration

General Medical Information

All travellers must complete parts 1 & 2 of this form.

Travellers who fit into the following categories also need to have a Doctor complete part 3

Apus Peru strongly recommends that you take out travel insurance that includes a medical component. If you have decided against this, please sign the Waiver in part 4.

People over 63 years old can TREK, if this form is completed with the approval of the Doctor.

People with heart conditions, knee problems, or are more than 18 weeks pregnant should not participate in TREKS / Multi-day hikes, but can participate in TOURS. People with severe asthma / diabetes / pregnant less than 18 weeks and any other condition that may affect their well-being while travelling are required to bring a medical letter from their doctor stating that they are fit to undertake the trek. They will also be required to be accompanied by a trekking companion on the trek at all times who will trek at their sides and be familiar with any medicines required in case of an emergency.

No sophisticated medical facilities are available the Andean region. This TOUR and /or TREK is intended for persons in reasonably good health and fitness. Passengers who are not fit for long trips for any reason, including disability, heart or other health condition, (that would entail an unreasonable risk to your health) are advised not to join the tour. Should any such condition become apparent, we reserve the right to decline to accept or retain you or any other passenger at any time during the trip.

Please return this completed form with registration, including Part III, Medical Advisor’s Opinion (if required). It must be received by time of final payment. In addition, you are advised to carry your own regular medication that may not be available in Peru. (We recommend travelling with this medication in your carry-on in the event of misplaced luggage by the airline. Syringes will not be allowed in carry-on bags.) Clients are further advised that medical evacuation, if available, is expensive, and that we strongly recommend that you have medical insurance that will reimburse you for this cost.

Important: We do not require these forms completed prior to booking, but if you make a booking and your Doctor completes part 3 indicating that you are unfit for the trek you have selected then Apus Peru reserves the right to not accept you for the trek. Please note that in this case your deposit is non-refundable.

Part I: Health Statement

I attest that I am in good general health, and capable of performing normal activities on this trek and tour. I understand that this tour will take me far from the nearest medical facility and that all trip members must be self-sufficient. With that understanding, I certify that I have not been recently treated for, nor am I aware of, any physical or other condition or disability that would create an impediment to myself or other members of the group completing the trip enjoyably.

I am an Asthma sufferer

If you suffer from asthma it is essential that you visit your doctor prior to your trip. During your tour / trek you will be at high altitudes, in areas that can be very cold, very dry, very humid and with animals present. Please ensure that your doctor is aware of this and that you travel with the appropriate medication for your condition.

Name

Date

Signature

Tour

Departure Date

Part II: Medical Information

Name

Blood Type

Date of Birth

Height

Weight

Evaluate your general health:

Fair Good Excellent

Evaluate your physical condition/stamina:

Fair Good Excellent

Have you taken out medical insurance

Yes No

Name & Number of Policy

If you have not taken out medical insurance please sign the Insurance Waiver in Part IV of this form.

1. Do you have any medical illnesses, disabilities or infirmities that have required the regular care of a doctor?

2. List all medications that you are taking at this time and the dosages and counter-indications.

3. Do you have any heart or respiratory problems? Are you a diabetic? Please elaborate.

4. Do you have any dietary restrictions, food or drug allergies? If so, what are they?

5. Do you have any physical or mental limitations, handicaps or prosthesis? Are you pregnant?

6. Name and phone number to be used in case of emergency. Relationship. If you are treated regularly by a doctor please also include their name and contact number.

Part III: Medical Advisor’s Opinion

Please give this form along with your itinerary to your personal physician.

Dear Doctor,

Our traveller is planning a tour to Peru, including a high altitude trek of days, where sophisticated medical facilities are unavailable. (Please cross out trek if not applicable to you.)

We would like to be sure that each of our passengers is in adequate medical condition for the Tour, including the trek (when applicable), and that we have the necessary background information about any health problems.

In addition to specific health issues that clients might have, we request the following people to seek their Doctor’s approval before confirming the trip.

People over 63 years old

People with severe asthma / diabetes / pregnant less than 18 weeks and any other condition that can affect their well-being during travel are required to bring a medical letter from their doctor stating that they are fit to undertake the trek. They will also be required to be accompanied by a trekking companion on the trek at all times who will trek at their sides and be familiar with any medicines required in case of an emergency.

We would appreciate your evaluation of:

1. His/her overall physical condition.

2. His/her ability to participate in this expedition and excursions.

3. Please elaborate on any medical conditions that you feel may be an impediment to the safe and successful completion of a high altitude trek.

Thank you for your help

Doctor's name

Date

Doctor's Signature

Phone

City, State, Country

Fax

Part IV: Medical Insurance Waiver

Apus Peru strongly recommends that you take out travel insurance that includes a medical component. If you don’t have this insurance, please complete the waiver below.

I, (name) recognize the risks of the tour / trek beginning on in which I am participating with Apus Peru SAC and assume all associated responsibilities in the event of the need for medical attention including but not limited to doctor’s visits, x-rays and laboratory tests, medical equipment, hospital stays and repatriation fees.

Location

Date

Client’s Full Name

Client Signature

What the Peru Health Declaration Form Is and When It Applies

The Peru Health Declaration Form is a traveler health questionnaire used to record personal identification, recent travel and contact details, current health status, and vaccination or test information required for entry or transit through Peru. It collects data for public health screening and contact tracing, and may be required by Peruvian immigration or public health authorities before boarding or upon arrival. The form can be submitted as a printed document or electronically where accepted; accurate completion supports border processing and reduces delays for travelers and carriers.

Why Completing the Form Properly Matters

Accurate completion helps authorities assess public health risk, speeds immigration and airline processing, and documents traveler status for contact tracing. Electronic submission can shorten wait times and reduce transcription errors while maintaining a verifiable audit trail for recordkeeping.

Who Typically Completes the Peru Health Declaration Form

The form is filled out by arriving or transiting travelers and by authorized representatives when travelers cannot complete it themselves.

Individual travelers completing personal travel and health details before departure or on arrival.
Airline check-in agents or travel agents submitting forms on behalf of booked passengers.
Consular or medical staff assisting passengers with special needs or minors.

Organizations such as airlines, travel clinics, and immigration officials also use form data to validate fitness to travel and for operational reporting.

Representative Signers and Delegated Submitters

Traveler

A natural person arriving in Peru who provides their full name, passport number, contact details, travel itinerary, health declarations, and signs the form to attest accuracy and consent to data use for public health.

Authorized Agent

An airline agent, family member, or travel representative authorized to complete and submit the form on behalf of a traveler who is a minor, incapacitated, or otherwise unable to submit it directly; agent attestations should be documented.

Key Data Elements Collected on the Form

Full name: Given and family names

Passport number: Passport or travel document

Contact details: Phone and email

Travel itinerary: Flight and arrival date

Health status: Symptoms and recent diagnosis

Vaccination status: Vaccine type and dates

Consequences of Incorrect or False Information

Denied boarding: Possible

Refused entry: Possible

Fines: Possible

Quarantine: Possible

Data flagging: Possible

Carrier liability: Possible

Common Preparation Mistakes to Avoid

Entering a nickname or abbreviated name that does not match passport details, which can delay boarding or immigration checks.
Providing an old passport number or expired travel document, causing processing errors and potential denial of boarding.
Omitting contact information for the stay in Peru, making contact tracing and arrival verification more difficult for authorities.
Rushing symptom or vaccination fields without checking dates, leading to inconsistent records or rejection of electronic submission.

Step-by-Step: Filling Out the Peru Health Declaration Form

Follow these steps in order to prepare and submit the form accurately before travel or at arrival.

01

Gather documents: Passport and flight information
02

Enter ID: Full legal name and passport number
03

Provide contact: Phone, email, lodging address
04

Sign and submit: Date and electronic or handwritten signature

How Submission and Verification Typically Works

Submission flows vary by carrier and point of entry; this outlines the typical chain from traveler to public health authority.

Traveler input: Traveler or agent completes the form
Carrier verification: Airline checks form before boarding
Arrival review: Immigration or health officers review
Data retention: Authorities retain for contact tracing

Attributes of a Professional Peru Health Declaration Form

A professional form reduces friction, ensures data quality, and supports electronic verification while meeting privacy and retention requirements.

Clear field layout

Group identification, travel, and health fields logically. Use required-field markers and inline guidance to prevent omissions and speed completion by travelers.

Validation rules

Apply format checks for passport numbers, dates (MM/DD/YYYY), and phone numbers to reduce transcription errors and improve downstream verification success.

Consent language

Include explicit consent for processing and storage of health data consistent with local privacy regulations and any carrier policies governing data sharing.

Audit trail

Capture timestamp, submitter identity, and delivery receipt when submitted electronically to support verification and dispute resolution.

Practical Tips for Accurate, Efficient Completion

Apply these checks to reduce errors and processing time at check-in or border control.

Match passport exactly

Enter your name and passport number exactly as shown on the passport. Small discrepancies can cause boarding denials and require manual correction by the airline or immigration authorities.

Use MM/DD/YYYY dates

Record dates in MM/DD/YYYY format where prompted. Use complete four-digit years to avoid confusion across international date formats during automated processing.

Keep proof of submission

Save a copy or confirmation email of the submitted form. Carriers and border officials may request proof of submission; an electronic copy speeds verification and reduces rework.

Update if status changes

If symptoms develop or travel plans change after submission, update the form or notify carrier and health authorities to ensure accuracy for contact tracing and public health decisions.

Key Time-Critical Steps Before and During Travel

Follow these sequential milestones to ensure form acceptance and avoid travel interruptions.

01

Pre-departure submission

Submit required form before boarding when carrier policy requires it

02

Airline check

Confirm carrier has accepted the form during check-in

03

Arrival screening

Present confirmation to immigration or health officers

04

Post-arrival follow-up

Provide updates if health status changes after arrival

Typical Timing and Deadlines for Submission

Deadlines vary; confirm carrier and Peruvian authority guidance for each trip.

Before boarding:

Many carriers require submission up to 48–72 hours before departure

At check-in:

Airline staff confirm form acceptance during check-in

On arrival:

Authorities may request form at immigration control on entry

If health changes:

Update the form as soon as possible after symptom onset

Retention period:

Authorities may retain records per local public health rules

What a Complete Peru Health Declaration Form Should Capture

A comprehensive form balances necessary public health data with traveler privacy and practical verification needs.

Traveler identity

Full legal name, passport number, nationality, and date of birth to match immigration records and verify identity during boarding and arrival processing.

Contact and address

Phone number, email, and lodging address in Peru for contact tracing and follow-up by public health authorities if required.

Travel itinerary

Flight number, seat if requested, arrival date, and onward travel to assist operational contact tracing and to locate travelers in case of exposure.

Health questions

Current symptoms, recent positive tests, or exposures with clear yes/no checkboxes and optional details for triage and quarantine decisions.

Vaccination details

Vaccine type, date(s) of administration, and supporting documentation fields where evidence upload is accepted for verification.

Attestation and signature

A signed declaration that information is true, plus date and submitter identity; electronic signatures should capture audit metadata.

How to Update or Amend a Submitted Form

Follow these methods depending on whether the form was submitted electronically or on paper.

01

Check carrier policy:

Confirm if carrier allows post-submission edits

02

Use online link:

Follow the editing link provided in confirmation

03

Contact airline:

Request assistance for updates before departure

04

Notify authorities:

Inform health authorities of material health changes

05

Resubmit if required:

Complete a new form when edits are not permitted

06

Retain records:

Save both original and revised submissions

Selected eSignature Pricing and Feature Comparison

Basic pricing and feature availability for common eSignature providers, with signNow listed first for consistent comparison.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies	Varies	Varies	Varies
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Frequently Asked Questions About the Peru Health Declaration Form

Answers to common questions travelers and administrators have when preparing, submitting, or storing the Peru Health Declaration Form.

Need help? Contact support

Is the form mandatory for entry?
Requirement depends on current Peruvian entry rules and carrier policies. Verify with your airline and official Peru health authority guidance before travel to confirm whether the declaration is required for your itinerary.
Can I sign electronically from the U.S.?
Yes where electronic submission is accepted. U.S. eSign legality is governed by the ESIGN Act (15 U.S.C. ch. 96) and by state UETA laws for intrastate matters; ensure the platform captures an audit trail.
Does submitting the form share my medical data broadly?
Data is used for public health purposes and may be shared with authorized agencies. Healthcare data handled in the U.S. may trigger HIPAA considerations when transmitted to providers; check privacy disclosures on the form.
What if I make a mistake after submitting?
If you can edit the submission via confirmation link, do so immediately. Otherwise notify the airline or public health authority and, if necessary, submit a corrected declaration as directed.
Can minors complete their own form?
Minors typically require a parent or guardian to complete and sign the form. Follow carrier and Peruvian authority guidance for signatures and consent for travelers under the age of majority.
How long should I keep my copy?
Retain the submitted declaration and any confirmations for at least three years for administrative records; healthcare-related information may require six years per HIPAA (45 CFR §164.530(j)).

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