Isolation Exemption Certificate

(filled by the Applicant )

Applicant in Name Gender [ ] Male

formation [ ] Female
Nationality Date of birth

Passport No. Mobile phone number

(Contact information
Status of stay
in Korea)

Address in Korea ※ Please provide a full address

Affiliation (Company name) Reference in Korea

(Contact information)

Last place of departure Date of departure

Flight No. Time and date of arrival

Period of visit Expected date of departure from Korea

(filled by the Embassy or Consulate)

※ △중요한 사업상(계약, 투자, 기술 지원 등) 목적, △학술적 목적(국제학술행사 등), △기타 공익적 또는

인도적 목적 등에 대한 상세 사유 적시

- 예시) 계약·투자 목적(기관명, 담당자, 계약·투자내용 등) / 학술적 목적(행사명, 주관기관 담당자, 행사일 등)
Purpose of
visit

Submitted
※ 초청장(초청 이메일 포함), 계약서(안) 등(여권 사본은 필히 징구)
documents

Although the person above is subject to the Special Entry Procedure upon arrival in Korea and isolation for
14 days after the entry, the person applied for exemption from isolation for reasons as stated above. The officer
in charge reviewed the request and hereby grants exemption to the applicant.
※ Isolation exemption certificate applies only to short-term visitors (B1, B2, C1, C3, and C4).
※ You will stay in a temporary isolation facility for two days for testing. If tested negative, you will be exempt
from isolation requirement.
※ In spite of this certificate, you will be isolated for treatment if tested positive.
※ You should follow the instructions of the health authority to install the Self-diagnosis App on your
smartphone and report your health status everyday through the app. You will also receive a phone call on a
daily basis from a public official assigned to you to report your health status.

Officer in Charge Title Name Phone number/E-mail

yy mm dd

Embassy(or Consulate) of
the Republic of Korea in 직인
________
 Quarantine Exemption for Short-Term Foreign Visitors to the Republic of Korea

In order to combat the COVID-19 pandemic, the Republic of Korea will require a mandatory 14-day self-
quarantine for all travelers entering Korea at either their place of residence or a government-designated
isolation facility, effective April 1, 2020 at 00:00 hours. This mandatory self-quarantine will apply to
everyone, regardless of nationality, except the short-term foreign visitors who are issued with an “Isolation
Exemption Certificate” from the ROK Embassy or Consulate General prior to the trip.

1. In order to apply for the “Isolation Exemption Certificate”, you must visit Korea on 90-day visa free
travel or with C1, C3, or C4 visa AND the purpose of the visit must be (a) important business/academic
activities, (b) activities related to public services, (c) urgent humanitarian reasons. If these two
conditions are met, you can apply to receive the Certificate by filling in the attached application form
and submitting it, along with any supporting document, to the Republic of Korea Embassy or Consulate
General. Once your application is approved by the Embassy or Consulate General, you will be issued
with the Certificate. You can contact ANY of the ROK Embassy or Consulate Generals below.

* Point of Contact for the Submission of “Isolation Exemption Certificate”

- ROK Embassy: email address / phone number (대사관 및 각 총영사관 작성)
- ROK Consular Office in Anchorage:
- ROK Consulate General in Atlanta:
- ROK Consulate General in Boston:
- ROK Consulate General in Chicago:
- ROK Consulate General in Dallas:
- ROK Consulate Agency in Hagatna:
- ROK Consulate General in Honolulu:
- ROK Consulate General in Houston:
- ROK Consulate General in Los Angeles:
- ROK Consulate General in New York:
- ROK Consulate General in San Fransisco:
- ROK Consulate General in Seattle:

2. When you arrive in Korea with the "Isolation Exemption Certificate", you will be escorted to a separate
facility outside of Incheon International Airport for COVID-19 diagnostic testing. The test result will be
available in 6 to 24 hours. Accommodation will be provided if an overnight stay is required.

a. If the test result is negative, you will be exempt from the 14-day self-quarantine. However, you will
be still subject to "Active Monitoring,” which includes daily submission of health status information
via “Self-Diagnosis App” and answering daily phone call from health authorities, throughout your
stay in Korea.

b. If the test result is positive, you will be moved to hospitals or designated treatment centers for
treatment/quarantine, regardless of the Isolation Exemption Certificate.

/END/