In view of the recent COVID-19 situation, all staff are required to fill up this declaration form for the ease of contact tracing.
Please complete the form by 08/04/2020 2359.
Thank you for your patience and kind understanding during this period!
My temperature is:
at or above 37.6°Cbelow 37.6°C
If your temperature is at or above 37.6°C, please specify
Are you feeling unwell or having any respiratory symptoms (such as fever, cough, sore throat or runny nose)?
Have you travelled to and from any country(ies) within the last 14 days?
Within the last 14 days, have you had contact with a COVID-19 confirmed case or suspect case, or a person issued Quarantine Order (QO) / Leave of Absence (LOA) / Stay-Home Notice (SHN)?
Do you have another job that is under the essential service sector? If yes, please specify.
If yes, please specify the job that you have in the essential service sector.
List down the time and location of where had you been today. (EG: Stayed home whole day/ Went to Angmokio shopping mall at 10 am)
By clicking "Send", you agree that all the information provided above is complete and correct
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