1. Are you a staff/student/visitor?




4. Have you traveled to any countries within the last 14 days?


if Yes, please state the countries:


5. Do you have any of the following symptoms (cough, fever, shortness of breath) ?
This question is required. *


6. Have you been in close contact with a case of COVID-19 infection?
This question is required. *


7. Have you been in transient contact with anyone who is suspected and/or diagnosed with a case of COVID-19 infection? This question is required.*


8. Have you been in contact with anyone who is on LOA/SHN or HQO in relation to COVID-19 infection?
This question is required.*


9. Please have your temperature taken and input in the field below.
This question is required. *


10. I declare that the above information given are true to the best of my knowledge.
This question is required. *