QUESTIONNAIRE FOR VISITORS

In view of the evolving Novel Coronavirus (COVID-19) situation and to reduce the risk of exposure, we require all visitors to complete a questionnaire. Your participation will enable us to take precautionary measures to protect you and everyone in the building.

Personal Particulars
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Declaration
6. Are you currently on Leave of Absence and/or Stay Home Notice (Refer to MOH's advisory on LOA/SHN)?

7. Do you have family member(s) or friend(s)/ relative(s) who are staying with you, and returned/arrived from overseas in the last 14 days?

*Close contact means having care for, having lived with or having direct contact with respiratory secretions or body fluids of a person with COVID-19.

8. Are you unwell with flu-like symptoms e.g. fever, headache, cough, sore throat, runny nose, breathlessness?

9. Have you been contacted by MOH/MND as part of contact tracing?

10. Please acknowledge the declaration below:

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