Information Needed to Process Humanitarian Testing Excep

Information Needed to Process Humanitarian Testing Exception
1. U.S. Citizen, U.S. National, Lawful Permanent Resident?
a. If no:
i. Nationality of passport traveled on
ii. Indicate Visa Type or if passenger has Electronic System for Travel
Authorization (ESTA)
2. Name (family name/surname, given name)
3. Age
4. Cell phone number (including country code) of passenger or head of household if family unit (if
available)
5. Email address where passenger or head of household if family unit can be reached
6. US destination address
a. Is US destination home address?
7. Flight itinerary, including any connecting flights
a. Airline
b. Flight #
c. Departure airport and date of departure
d. Arrival airport and date of arrival
8. Any COVID-19 vaccines received to date, if applicable (list product name and date for each dose)
9. Purpose of travel to the US and a brief explanation of why urgent travel is needed
10. Justification for humanitarian exemption for testing requirement (e.g., no testing available where
passenger is located)
11. Documentation to support justification (e.g., medical records, orders for emergency evacuation)
12. Information regarding any other solutions that were sought prior to application (e.g., flight
changes, testing en route, assistance in obtaining testing/vaccination, etc.)