TB declaration form

If the country of your nationality is not on the list of exemptions below, the IND requires you to complete a ‘Declaration of intent to undergo a TB test’. By completing and signing this form, you declare that you are prepared to undergo a tuberculosis (TB) test and – if necessary – treatment after your arrival in the Netherlands.

When filling out the form, make sure that:

• you check the ‘yes’ box at 1.1
• you leave the V number at 1.2 blank
• your name and personal details match the details on your passport exactly
• you leave questions 2.4, 2.5 and 2.6 blank if you are 18 or older. If you are under 18, a parent or guardian must answer these questions. In this case, you must also provide a scan of the passport or ID card of your parent/guardian.

Important: the IND does not accept digital signatures. This means you will need to print the form, fill it out, sign it with a pen and scan it.

Declaration of intent to undergo a TB test from Immigration and Naturalisation Service appendix (pdf). There are a few exemptions from the obligation to undergo the test. See Exemption from the obligation to undergo a tuberculosis (TB) test appendix (pdf).

After arrival, take the TB test

If your nationality is not included in the exemption list, you will have to undergo a tuberculosis test in the Netherlands. You must take this test within three months of arriving. You will receive an e-mail with more information about the TB test at the end of February.