Health and Safety Questionnaire

    Please fill up the following questionnaire: the information gathered from these questions will be used for Health and Safety purposes.

    1. Are you experiencing any flu like symptoms, such as chills, cough, and shortness of breath or body aches?

    If yes, please mention the accurate date when it first appears.

    2. Is any member of household displaying symptoms?

    If yes, please mention the date of their symptoms appear.

    3. Have you been in contact with anyone who has tested positive for COVID-19?

    If yes, when?

    4. Have you travelled internationally in the past 14 days?

    If yes, when and where?

    5. Do you use PPE (masks, gloves, sanitizer, etc.) while in public spaces, such as grocery stores?

    6. Is your body temperature above 38 degree celsius?