About this template
Airlines, charter operators, and travel agents must collect mandatory health disclosures and attestation documents from air passengers traveling to the United States. This Passenger Disclosure and Attestation form simplifies compliance with federal regulations by providing a clear, digital method to gather required passenger confirmations, contact details, and electronic acknowledgments before departure.
Designed to streamline pre-flight checks, this template eliminates the friction of paper forms, manual printing, and scanning. Passengers can easily complete the attestation on any smartphone, tablet, or desktop device. With Doc2Form, you can instantly turn this structured layout into a live Google Form, ensuring all responses are safely captured in a centralized spreadsheet for quick review by ground staff and compliance officers.
Whether you operate commercial flights, private charters, or group travel packages, this form ensures you capture all necessary legal disclosures accurately while delivering a smooth, professional experience for every traveler.
Key features
- Collect required CDC and federal travel disclosures digitally
- Gather verified passenger names, flight details, and contact info
- Streamline pre-flight compliance and passenger onboarding
- Store all attestations securely in a centralized spreadsheet
- Deploy instantly to passengers via email or QR code
Use cases
- Commercial and charter airline pre-flight passenger clearance
- International group travel and tour operator compliance checks
- Private aircraft operator regulatory documentation
- Travel agency pre-departure verification workflows
What this form collects
- Passenger Full Name (Short answer)Enter your full legal name exactly as it appears on your passport.
- Date of Birth (Date)Provide your date of birth for identity verification.
- Airline and Flight Number (Short answer)Enter your airline name and flight number (e.g., Delta DL123).
- Date of Departure (Date)Select the scheduled date of your flight to the United States.
- U.S. Destination Address (Paragraph)Provide the address where you will be staying upon arrival in the U.S.
- Contact Phone Number (Short answer)Provide a phone number where you can be reached during travel and after arrival.
- Email Address (Short answer)Enter your email address to receive a copy of your confirmation.
- Health Attestation Confirmation (Multiple choice)Please confirm that you meet all current health and testing requirements for entry into the United States as mandated by the CDC.
- Proof of Negative Test or Recovery Documentation (Paragraph)Please paste a link to your digital test result or recovery document (Google Drive, Dropbox, etc.), or describe your documentation.
- Passenger Signature / Acknowledgment (Short answer)By typing your full legal name below, you certify under penalty of law that the disclosures and information provided are true and accurate.
FAQ
How do I share this form with passengers?
Once you convert this template using Doc2Form, you can share the Google Form link via email, text message, or print a QR code for check-in desks.
Can I customize the questions on this form?
Yes. Since the form lives in your Google account, you can freely edit, add, or remove questions to match updated travel requirements.
Where are passenger responses stored?
All submissions are automatically saved to a linked Google Sheets spreadsheet, giving your operations team instant access to response data.
Is this form mobile-friendly for travelers?
Yes, Google Forms are fully responsive and work seamlessly on mobile browsers so passengers can complete their attestation on the go.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.