Your name, surname
Please indicate the reason of your self-isolation
I have arrived from foreign country
I was exposed to someone with COVID-19 disease (coronavirus infection)
Do you currently have any characteristic symptoms of acute upper respiratory infection?
Yes
No
Please add the document proving the negative test for COVID-19 performed not earlier than 48 hours ago
Please upload the file here
County of your current self-isolation place
Your telephone number
Your e-mail
Planned date of your departure from the isolation place
Planned time of your departure from the isolation place
