Health Declaration Form
The safety of our customers and staff remains our top priority. As the outbreak of COVID-19 continues, we remain vigilant in preventing its spread. Please answer this form truthfully.
Full Name
Last Name
First Name
Age
Sex
Male
Female
Contact Number
1. Did you visit a hospital, clinic, or any medical health facility in the past 14 days?
Yes
No
2. In the last 14 days, have you been in close contact with a suspect case, a probable case, or a confirmed COVID-19 positive patient?
Yes
No
3. In the last 14 days, did you have any of the following:
Fever
Colds
Cough
Sore throat
Difficulty in Breathing
None
Certification & Data Privacy Consent
By signing in the box above, I certify that the information I provided are true and accurate. I hereby give my full consent to Kiss The Tiramisu to collect, record, and process information, whether personal, sensitive, or privileged, pertaining to myself for the purpose of drafting and implementing internal policies related to the prevention or containment of COVID-19.
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Classic Tiramisu
265
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Matcha Tiramisu
285
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Classic Tiramisu
300
PHP
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Matcha Tiramisu
300
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Oreo Mousse
250
PHP
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Breakfast
Tiramisu Pancake
200
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Matcha Tiramisu Pancake
200
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Truffle Mushroom
350
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Korean Gochujang
250
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Aglio Olio
200
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Americano
80
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Café Latte
100
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Vanilla Latte
120
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Matcha Latte
140
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Cappucino
100
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Caramel Macchiato
140
PHP
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Café Mocha
120
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Cream Cheese Latte
200
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Tiramisu Cheese Cream Latte
220
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Caramel Cheese Cream Latte
210
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Kissing Coffee
160
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Tiramisu Ice Cream Latte
190
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Tiramisu Affogato
210
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Caramel Affogato
200
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Sikhye
180
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30
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Tea
Rose Green Tea
100
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