24th / 25th August 2024
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Covid-19 Screening Questionnaire

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  2. Covid-19 Screening Questionnaire

    Have you travelled to a high risk country in the last 14 days? (required)

    Have you had contact with anyone with confirmed COVID-19 in the last 14 days?
    If YES, provide details:

    Please provide details below:

    Do you suffer from any of the following symptoms?

    Fever:

    Cough:

    Sore Throat:

    Shortness of breath:

    Body aches:

    Loss of Smell:

    Loss of taste:

    Nausea:

    Vomiting:

    Diarrhoea:

    Fatigue:

    Weakness:

    Tiredness:

    Temperature Measurement Result

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