1. Are you a staff/student/visitor?

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

if Yes, please state the countries:

4. Have you been in close contact with a person suspected and /or diagnosed with Novel Coronavirus Pneumonia?

5. Please have your temperature taken and input in the field below before entering the office premise.

6. I declare that the above information given are true to the best of my knowledge.