Fill in the 6 questions with YES or NO.
If YES, fill in the answer column with numbers 1 or 5.
If NO, fill with number 0.
In the past 14 days,have you experienced any of the following:
SORRY, you cannot do Raja Ampat Online Registration.
High Risk (Resiko Besar) is not allowed to enter Raja Ampat Regency. We recommend that you consult a health worker.
Thank you for conducting an Honest Covid-19 Risk Self-Assessment.Make sure your body is in a healthy condition with a body temperature of
Please continue to Online Registration.
Your form is saved successfully!
If you want to continue answering your form later, please enter the email address you would like to send the link to:
Something went wrong while saving your answers. Please try again.
We’ve sent you an email with a link to complete your submission.