American Samoa Health Declaration Form
https://nl.ivisa.com/american-samoa-health-declaration-form
It is highly recommended to fill in the American Samoa Health Declaration Form at least 21 days prior to your departure. It does not matter if you're traveling by sea or air. However, due to varying CO Sindications, regulation may vary depending on the nation of origin. You must understand that no one will check your health on board nor can they demand you to do so when you land at their port of call. It is important that you declare your health.
In American Samoa there are several laws and regulation regarding health issues. In spite of this, American Samoan enjoy freedom of choice as regards to health issues. A resident of American Samoa may freely choose the healthcare professional or any other healthcare provider that he or she would like to see. American Samoan institutions require that healthcare professionals, such as doctors or nurses, have specialized credentials. American Samoan institutions will issue the health declaration form to the doctor or nurse.
As a legal stipulation, American Samoans who wish to seek treatment in the USA must first complete and sign a health declaration form. The health declaration form includes details about the applicant's medical history and physical condition. The applicant must also provide information about his or her citizenship, permanent resident status, and immigration status. The laws, regulations, and rules of American Samoan Health Administration (SAMOA) determine the time a person must be treated at a domestic Caribbean or American Samoan hospital.
This is usually done by filling in a HIPAA form. The HIPAA regulates the privacy of personal health information, outlines how protected information can be disposed of and established certain guidelines for the security of personal health information. To obtain a passport for American Samoa, applicants must sign and return to the Consular office or Embassy a copy the HIPAA insurance card. This is important as all health care providers in American Samoa are required to register with SAMOA. This ensures that all healthcare providers who treat American Samoans adhere to international standards regarding privacy and health care. Even if one doesn't have an American Samoa passport, one can still access healthcare services in American Samoa.
Before one receives healthcare services he or she must obtain a Health Insurance Card or a Health Declaration. A Health Insurance Card is a document that proves your identity, and allows you to access health care in American Samoa. It can also be used to provide additional medical assistance in an emergency. An individual who holds an American Samoa Health Insurance Card must show this card at the time of application for healthcare services. American Samoa does not allow anyone to apply for health services without a valid health insurance card.
It is advisable to get a Health Declaration if you or anyone in your family is suffering from an ailment or disease which could potentially result in financial loss. This is because you will need to have health insurance in case you need surgery or major medical treatment. For example, someone who has diabetes will require an insulin prescription. A bone scan or tissue scan is required for anyone undergoing treatment for cancer. A medical examination will determine the amount of your monthly out-of-pocket medical expenses. Your declaration will also provide a list of all diseases or medical conditions you have, their treatments and the amount you will be reimbursed for such treatments.