FEEL Safe here

Hi, We have taken all necessary precautions, all we ask is you do the same. Please go through our process.

HEALTH DECLARATION AND CONTACT FORM

MG SAN FERNANDO Contact Tracing Form

Name

Gender *

Have you tested positive or been presumptively positive with Covid-19 or been identified as a potential carrier of the virus or similar communicable diseases? *
Have you been in direct contact with any person from your household, workspace, travels; and/or visited a healthcare facility used for COVID-19 quarantine purposes in the last 30 days? *
Have you travelled by plane to a domestic location outside of Metro Manila within the last 30 days? *
Have you travelled or transited outside of the country within the last 30 days? *
Are you experiencing any symptoms commonly associated with the Coronavirus? Please select applicable answers. *

By clicking the Send button, I am authorizing and giving my consent to the ANC Group of Companies and its accredited third-party partners to collect, store, share and process my information as required by RA 10173 and other applicable laws and regulations.

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