Covid Health Declaration Form Template Philippines

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Covid health declaration form template philippines. Who is still under quarantine. Following cdc guidelines come up with steps to prevent infection and mitigate the spread of the disease. Explain the circumstance of exposure.

In the preceding 14 days i have not been in close contact with a person who has been. To prevent the local transmission of corona virus covid 19 by virtue of eo no. You can choose the option to encrypt the responses with jotform to ensure the privacy of responses from our customers.

Whether you re an employer or manage hr for a company this free coronavirus self declaration form allows members of your staff to confirm if they have coronavirus so they can proceed to seek medical treatment and prevent further contamination in your workplace. Declaration form for personnel 1. Declaration form covid 19.

Use this covid 19 risk assessment template to conduct a risk assessment in your workplace and determine your organization s vulnerability to covid 19. Business name we require you to complete this declaration in relation to the coronavirus covid 19. Covid 19 coronavirus risk assessment template.

Sharing this health declaration form that is intended to be used by many businesses is based on the health declaration forms used by the philippine house of representatives and malacañan palace in relation to the covid19 response. I am not awaiting a covid 19 test result nor do i reside with a person who is awaiting a covid 19 test result. Republic of the philippines department of health office of the secretary decision tool for coronavirus disease 2019 covid 19 assessment as of february 26 2020.

This health declaration form covid19 is useful when you travel to china and you want to state that you are there for a temporary time and state that you are healthy. Under articles 171 and 172 of the revised penal code of the philippines. A coronavirus self declaration form is used by individuals infected with covid 19 to report their medical status.