Health Declaration Form

Dear Sir/Madam

To prevent the spread of novel coronavirus (Covid-19) in our community and reduce the risk of exposure to our staff and visitors, we require you to complete this screening questionnaire prior to entering SJMC premises.

Thank you.

Please enter N/A if not applicable

Describe if you selected others.



Dear Sir/Madam (Chinese)

To prevent the spread of novel coronavirus (Covid-19) in our community and reduce the risk of exposure to our staff and visitors, we require you to complete this screening questionnaire prior to entering SJMC premises.

Thank you.

Please enter N/A if not applicable

Describe if you selected others.



Dear Sir/Madam (Bahasa Malay)

To prevent the spread of novel coronavirus (Covid-19) in our community and reduce the risk of exposure to our staff and visitors, we require you to complete this screening questionnaire prior to entering SJMC premises.

Thank you.

Please enter N/A if not applicable

Describe if you selected others.



Dear Sir/Madam (Malay)

To prevent the spread of novel coronavirus (Covid-19) in our community and reduce the risk of exposure to our staff and visitors, we require you to complete this screening questionnaire prior to entering SJMC premises.

Thank you.

Please enter N/A if not applicable

Describe if you selected others.