Visitor Declaration Form COVID 19
In an effort to reduce the risk of COVID-19 exposure to KoMiCo Technology Singapore Pte Ltd employees, all visitors must complete the following screening questions:
Date & Time
Name
First Name
Last Name
Company details
Company's Name
Reason
Name of KTS staff/department visiting
Name
Department
Visitor Temperature in C :
Above 37.5 C will not be allowed in KTS premise
Back
Next
Self-Declaration by Visitor
Have you travelled to COVID affected countries or been in close contact with anyone who has travelled to those areas within the last 14 days?
Please Select
Yes
No
Have you had close contact with or cared for someone diagnosed with COVID-19 or issued with Stay at notice within the last 14 days?
Please Select
Yes
No
Have you experienced any fever,cold or flu-like symptoms in the last 14 days (fever, cough, shortness ofbreath or other respiratory problem)?
Please Select
Yes
No
Visitors answering yes to any of the above questions will not be permitted access to KoMiCo Technology Singapore Pte Ltd's premises.
Visitor's Signature
KTS approving Staff Name
Approval to Access facility
Please Select
Approved
Denied
KTS staff Signature
Submit
Should be Empty: