Travel Declaration and Contact Tracing Form for Visitors

To prevent the spread of COVID-19 in our community and reduce the risk of exposure to our staff and visitors, we are conducting a simple screening questionnaire. Your participation is important to help us take precautionary measures to protect you and everyone.

Management has the right to refuse entry / service for those who have a temperature of 37℃ or higher and unwell displaying respiratory symptoms.

Thank you for your time.

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If you have the following symptom(s), please tick the relevant box(es)
Have you been in contact with a confirmed COVID-19 patient in the past 14 days?
Have you been to affected countries/regions in the past 14 days?
Would you like to receive more news update from Pita Tree?

Upon clicking ‘submit’, you declare that the above information is true at the point of submission and are agreeable to adhere to social distancing measures by the government. 
Anyone making false declarations is liable to be prosecuted under the Infectious Diseases Act.