MM Travel Declaration Form

Name *

First Name

Last Name

Have you travelled out of Singapore in the last 14 days? *

Yes

No

Did you, in the last 14 days, come into close contact with someone who is a confirmed COVID-19 case, or is part of a COVID-19 cluster? *

Yes

No

Do you have any flu-like symptoms? *

Eg. Fever, cough, etc.

Yes

No

*

I hereby declare that the above statements are true, accurate, and complete.