Contact Trace
- Corporate Office
Employee Information
Employee ID No
Temperature
Temp. must be between 35°C and 41°C
Are you experiencing:
Soar Throat
(pananakit ng lalamunan / masakit lumunok)
Yes
No
Body Pains
(pananakit ng katawan)
Yes
No
Headache
(pananakit ng ulo)
Yes
No
Fever for the past few days
(lagnat sa mga nakalipas na araw)
Yes
No
Have you worked together or stayed in the same close environment of a confirmed COVID-19 case?
(May nakasama ka ba o nakatrabahong tao na kumpirmadong may COVID-19 / may impeksyon ng coronavirus?)
Yes
No
Have you had any contact with anyone with fever, cough, colds, and sore throat in the past 2 weeks?
(Mayroon ka bang nakasama na may lagnat, ubo, sipon o sakit ng lalamunan sa nakalipas na dalawang (2) linggo?)
Yes
No
Have you travelled outside the country in the last 14 days?
(Ikaw ba ay nagbyahe sa labas ng bansa sa nakalipas na 14 araw?)
Yes
No
Name of place(s) visited
Date of Travel
I hereby declare that the information given in this application is true and correct.
I hereby accept the
Terms and Conditions.
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Corporate Office