Covid-19 Health Declaration | bellcitymelb

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Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

Phone

Company

Clock In

Date

My body temperature is lower than 37.5°C

I am not experiencing the symptoms: fever, chills, cough, sore throat, shortness of breath, runny nose, loss of sense of smell

I haven’t been in close contact with a Covid-19 patient in the last 14 days

I declare that the info I’ve provided is accurate & complete

Thanks you!

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Preston, VIC 3072 | +61 3 9485 1000

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