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Covid-19 Health Declaration

How are you feeling today?

Have you traveled withn or outside the Phlipines for the last 14 days? If yes, kindly indicate below:
Do you have any of these symptoms, r have you ha any of thesee symptoms in the last 14 days? (Please check all that apply.)
Did you visit any healh clinic, hospital or nursing home in the past 14 days? If yes, kindly indicate specific establishment
Have you been in contact with a suspeted or confirmed COVID-19 patient for thepast 14 days?
Do you have any family/household members or close friends who have met a person currently having flu-like symptoms (e.g feer, cough colds) or respiratory problems?
Have you undertaken any COVID Test? If yes, kindly provide the following information

Thanks for submitting!

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