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  • Personal Profiling Form

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    Jinky Asilo
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    This document collects information about an employee, including their address, type of residence, details of any roommates or household members, where household members go on a weekly basis, where the employee buys food and other essentials, places visited weekly and on weekends, and how the employee travels to access essentials. It aims to understand the employee's living situation and movements in order to assess potential exposure to COVID-19.

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    This document collects information about an employee, including their address, type of residence, details of any roommates or household members, where household members go on a weekly basis, where the employee buys food and other essentials, places visited weekly and on weekends, and how the employee travels to access essentials. It aims to understand the employee's living situation and movements in order to assess potential exposure to COVID-19.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    14 views1 page

    Personal Profiling Form

    Uploaded by

    Jinky Asilo
    This document collects information about an employee, including their address, type of residence, details of any roommates or household members, where household members go on a weekly basis, where the employee buys food and other essentials, places visited weekly and on weekends, and how the employee travels to access essentials. It aims to understand the employee's living situation and movements in order to assess potential exposure to COVID-19.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Name of Employee _________________________________________

    Address _________________________________________

    TYPE OF RESIDENCE

    Own Rented

    House Condo Apartment/ Townhouse Rented Room Bedspace

    If rented room / bedspace how many in the room? ____________________________________

    Please indicate details of room mate under the provision on members of household

    MEMBERS OF THE HOUSEHOLD

    NAME RELATIONSHIP AGE WORK / ACTIVITIES WITH HEALTH CONDITIONS


    (Y/N) indicate details

    HOUSEHOLD MEMBERS WHO GOES OUT OF THE HOUSE MORE THAN ONCE PER WEEK

    NAME WORK / WHERE DO THEY FREQUENCY REMARKS


    ACTIVITIES GO

    WHERE DO YOU BUY FOOD ESSENTIALS

    Online Grocery Wet Market Community Market

    WHAT PLACES DO YOU VISIT WEEKLY

    Grocery Wet Market Meat Shop Drugstore Hardware

    Park Banks Bakeshop Laundry Shop Community Center

    Salon / Parlor / Barbershop Fastfood / Rest Tennis Court / Basketball Court

    WHERE DO YOU GO DURING WEEKENDS

    Mall Relative House _______________ None, stay at home

    HOW DO YOU TRAVEL TO ESSENTIALS

    Use own car Walking Riding the Bike tricycle by Grab/Taxi

    by Jeep by Bus

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