Self-Declaration Health Form

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To be completed by students of Taylor's International School, KL.

We, at Taylor's Schools are taking the necessary precautionary measures against the spread of COVID-19 Infection into our school/work areas. You are kindly requested to declare your health status on this form as required under Section 15 of Prevention and Control of Infectious Diseases Act 1988.
Thank You.

Full Name: *

Class *

Declaration by student *

Yes

Have you travelled abroad (i.e. to any countries outside of Malaysia including Sabah/Sarawak) in the past 30 days?

Do you have flu-like symptoms (e.g. fever, cough, runny nose, sore throat or loss of taste / smell, etc.)?

Did you, in the past 14 days, come in close contact with someone who (i) is a confirmed COVID-19 case; OR (ii) is part of a COVID-19 cluster?

I hereby declare that all the entries in this form are true and correct. I authorize Taylor's Education Sdn Bhd or its subsidiaries, to disclose my personal information to its employees for administration and record purposes or to be used for contact tracing (if required).

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