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https://fr.ivisa.com/dominican-republic-travelers-health-affidavit

Dominican Republic Travelers, it is an absolute requirement to carry a Dominican Republic Travelers Health Affidavit for each step of traveling outside the island. As per the International Health Care Services Act(IHCSA) all healthcare insurance will be immediately announced on entry to the country. However, this doesn’t apply to Dominican Republic Travelers who is entering through the points of entry such as Punta Cana or San Juan. Where you are entering the Dominican Republic, you’ll need to have the proper IHCSA documentation in hand to be medicated by the suitable healthcare providers. Failure to do this can lead to significant fines and charges from you.