Health Declaration Form Question Title * 1. Name Question Title * 2. Date of training Date Date Question Title * 3. Company / Department Question Title * 4. Contact Number Question Title * 5. Have you travelled within the last 14 days? Yes (If selected Yes, please contact FTR directly) No Question Title * 6. In the last two weeks, have you been in close contact with anyone suffering from symptoms of COVID-19 or diagnosed with COVID-19? Yes (If selected Yes, please contact FTR directly) No Question Title * 7. Do you suffer from any of the following symptoms? Fever Mild or moderate breathing difficulties Sore throat Muscle aches or body aches Vomiting or diarrhea Loss of taste or smell Congestion or runny nose None of the above Done
