Undertaken to Implement the Home Quarantine Procedure for Arrivals 1, the undersigned, declare that 1 have been informed about the health measures and the ‘medical instructions that 1 should compel. In addition, | understand the risks that could be posed to community in the event of non-compli- ance, so for the sake of the public health and to avoid the legal accountability under the federal law No (14) for 2014 on fighting the communica- ble diseases, | hereby declare that | will not leave the house nor get in contact with others, and adhere to infection control guides until the end of the prerequisite health measures , and the dura tion of the quarantine which is 14 days starting from the my arrival date to United Arab Emirates. Accordingly, | filled in my personal information and signed up Full Name Passport / ID No.= Mobile & landline Number: Address Next f kin or sponsor Name & Phone No | emai Date & signature oun @ ual prot lelped uate gals 31,5! “pull ga Catal pRameall olalya Ml 2b i aly st ois gay! Lt pbAst cyl gl LS Lge onl Rylll aL YI le Lege 1 ual jl pate Je 2 cially, Gain al ogiall Gay Aigilal USL Lindy Abd! decal! stgsl «2014 Rind 14 fod) Syl Gl aH goles! OepSV dalle pany al JUV) Lull ayalie paw JLSiuel Quad Ulldy gga! JLASI! gia cobs ¢Lily gruel pol 5% pLaily Appl Qeesall lal yt aLjLegl Bigs Gl papa Gaal Gee Iybsel Lage 14 3a yp aed 6 Me cling Saecll Ay yall pul eangg Ayucniell Jala ga tg pal lon ey ply pal aly ay Soles Sect) sD sol dag eat ASI sal Sean yaa sala dale! ale deat algal ea iil 46jLbe le Ga) —) | agree to share my data with the competent authorities fr che purposes of follow-up and scientific studies |_