Staff Travel History/ Health Declaration Form

Written by Rose Lam | Jun 1, 2021 8:51:38 AM

[Template] Staff Travel History/ Health Declaration Form

Name:

 

NRIC/ Passport No.:

 

Nationality:

 

Date Of Birth:

 

Contact Details:

__________________(O)

__________________(HP)

__________________(H)

Email :

 

Business Unit:

 

Date of Departure from Singapore:

 

Length Of Stay:

 

Date of Arrival to Singapore:

 

Itinerary

(in exact order)

Destination (Countries/Cities)

Duration Of Stay (Days)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please tick the following boxes if you are experiencing/ experienced any of the following symptoms:

 

  Fever   Dry Cough   Body Aches
   Sore Throat   Runny Nose   Tiredness
   Headaches   Others    

 

 

Reference Guide

Goh, M. H. (2016). A Manager’s Guide to Implement Your Infectious Disease Business Continuity Plan, 2nd Edition. GMH Pte Ltd.

Do You Want to Continue Training During A Pandemic Outbreak?

Due to the pandemic outbreak, BCM Institute will be conducting its certification courses via interactive video conferencing, online and e-learning mode. Find out more about the Business Continuity Management (BCM) and Crisis Management (CM) Blended Learning (BL) courses.

For this period, the content will include the managing and implementing of the Pandemic Influenza plans.


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
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