Professional Documents
Culture Documents
Health Declaration Card: Republic of The Philippines Province of Aklan
Health Declaration Card: Republic of The Philippines Province of Aklan
NA
HEALTH PROFILE
1. Have you been sick (cough, difficulty breathing, colds, sore throat, fever) in the past 30
days?
[ ] Yes [ ] No
2. Have you been exposed to a confirmed case of COVID-19 ? [ ] Yes [ ] No
3. Have you been tested positive for COVID-19 using RT-PCR Test ? [ ] Yes [ ] No
Travelers
Upon submitting, I am providing consent to sharing my information for contact tracing
purposes, I confirm that the information I have given is true, correct and complete and that I
understand failure to answer any question may have serious consequences under Philippines
laws. (Article 171 and 172 of the Revised Penal Code of the Philippines)
a61e7754-0ea4-4672-b727-e3cf3f27fdc5
Provincial Government of Aklan Signature