Questionnaire quarantine assistance

Felder mit einem * sind Pflichtfelder und müssen ausgefüllt werden.

1. Which country are you from?

2. Do you need help on your first day of arrival?

yes

3. Do you know someone living in Germany who could help you?

yes

4. When exactly will you arrive in Germany? (Date and Time!)

5. Where will you stay after arriving in Germany? Where will you quarantine? (Adress)

6. Are there any specifics in your diet? (e.g. vegetarian)

yes

If yes, what exactly?

7. Do you have allergies?

yes

If yes, what allergies?

8. What is your name?

9. What is your gender?

male

female

diverse

10. What is your email adress and phone number?

11. What is your phone number? *

12. Are you fully vaccinated? (In Germany, you are considered as fully vaccinated 14 days after the 2nd vaccination dose). *

yes

13. If yes, which vaccine did you receive? (BioNTech, AstraZeneca, ...)

I agree that my data will be saved and passed on to potential helpers for the purpose of quarantine assistance. *

Sicherheitsüberprüfung (Spam-Schutz)

Bitte geben Sie den abgebildeten Code in das folgende Feld ein:

* Pflichtangabe