Covid-19 Contact tracing

In view of the Covid-19 outbreak, we will need all visitors to register and fill the questionaire, inline with MOH guideline. 

We thank you for your co-operation. 

Name as per in NRIC *

Mobile No *

Company *

QUESTIONAIRE (If your answer is YES for anyone of below, please do not proceed to enter this premises. *

Have you been out of Singapore in the last 14 days? Yes/No *

If the answer above is 'Yes', please list the country *

Have you been in close contact with someone from Europe, Iran, South Korea, mainland China or a suspected Covid-19 individuals in the last 14 days? Yes/No *

Do you have flu-like symptoms (eg fever, cough, running nose, sore throat, etc)? Yes/No*

Temperature reading *

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