Coronavirus COVID-19 “self-declaration” form

 
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1. Have you been in China in the last 15 days or are you coming from a Chinese airport?
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2. Have you passed through the Municipalities affected in Italy in the last 15 days?
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3. In the last 15 days, have you had contacts with someone who has been in China / Italian areas affected and had symptoms such as cough and / or fever?
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4. Have you had any of the following symptoms in the past 15 days?  
Temperature rise above 37.2
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Cough
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Worsening of general physical conditions
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5. Touch to Take A photo with ID Card
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I hereby undertake to inform Company if, in the next few days, I find any health problems related to "Coronavirus - Covid 19", so that the company can carry out further checks with the people I met at the company site.
 
ส่งข้อมูล
COVID-19 Self Declaration by K2 Blackboard version 1.0 CP
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