Avoid  going abroad or crowded public space during the holiday, and wearing mask while entering the administrative offices.

All inbound events are postponed till July 31st.

外國學者蒞校ENG 4

 

Novel Coronavirus Health Declaration

During the past 14 days,

1.    Have you had fever, cough, or shortness of breath? (if take medications, please answer "Yes")

£ YES   £ Fever  £ Cough  £ Shortness of breath

£ NO

2. TRAVEL HISTORY

Have you been to (including transfers)?

£ China, Province                   

£ Hong Kong

£ Macao

£ Other Countries or cities                        

£ None of the above

3.    CONTACT HISTORY

Have you been in contact with

£ Fever or flu-like symptoms persons

£ Birds, ducks, etc.

£ Livestock such as pigs, cats, dogs, etc.

£ None of the above

4. CLUSTER HISTORY

(1) Living with family members who is/are

Home isolation Home quarantine

Independent health management (Due Date:             )

None of the above

(2) Family / friends / colleagues status

Family also has fever or flu-like symptoms

Friends also have fever or flu-like symptoms

Colleagues also have fever or flu-like symptoms

None of the above

*Be sure to wear a mask in public places during following 14 days.

Signature                           

 

Date                   

 

 

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