Registration as contact

If you live in Germany, you can use this form to contact your local health authority.

1. Personal information

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Your birthday in the format: DD.MM.YYYY.
 
 

2. Address

Note: currently, the Digital Waiting Room is only available in Germany.

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Please enter your post code.
District, independent city or county
 

3. Contact

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not required, but recommended
 

4. Source of Infection

Please provide information regarding your exposure to possible sources of infection.

e. g. John Smith, the Club-XY, Italy / China etc.
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Please indicate the day on which you were last in contact with this person or on which you have last been to this place.
 

5. Closeness of contact

Please select which category you would classify yourself and give a brief explanation.

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Please briefly justify your classification in the above category.
 

6. Symptoms

Do you suffer from respiratory symptoms (cough, sore throat, runny nose) or fever?
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7. Underlying Diseases

Please select all underlying diseases that you have.
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Submit

By sending the form, your data will be automatically transmitted to the health authority responsible for you. We will determine the health office responsible for you on the basis of your postcode and the assignment of health offices by the RKI.