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  • Post Examination Health Surveillance Form: Annex "C"

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    kathy princess flores
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    Annex “C” is a post-examination health surveillance form required to be submitted 15 days after taking a licensure exam. The form summarizes the examinee's health status on a given date after the exam. It requires the examinee to provide their name, profession and exam date. They then check boxes indicating their current health status, including whether they have fever, cough, fatigue, or other symptoms. Upon completing and submitting the form, the examinee will receive an acknowledgment or further instructions from the Professional Regulation Commission.

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    2020-68 Annex C - Post Examination Health Surveillance Form101620 (1)

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    Annex “C” is a post-examination health surveillance form required to be submitted 15 days after taking a licensure exam. The form summarizes the examinee's health status on a given date after the exam. It requires the examinee to provide their name, profession and exam date. They then check boxes indicating their current health status, including whether they have fever, cough, fatigue, or other symptoms. Upon completing and submitting the form, the examinee will receive an acknowledgment or further instructions from the Professional Regulation Commission.

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

    Post Examination Health Surveillance Form: Annex "C"

    Uploaded by

    kathy princess flores
    Annex “C” is a post-examination health surveillance form required to be submitted 15 days after taking a licensure exam. The form summarizes the examinee's health status on a given date after the exam. It requires the examinee to provide their name, profession and exam date. They then check boxes indicating their current health status, including whether they have fever, cough, fatigue, or other symptoms. Upon completing and submitting the form, the examinee will receive an acknowledgment or further instructions from the Professional Regulation Commission.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    Annex “C”

    Post Examination Health Surveillance Form

    s: Please continue to follow social distancing and the wearing of face mask
    the exam. You are required to send an email at the official email address of the
    Office where you take your licensure examination 15 days after the last
    n date. Please provide truthful information relative to your health status.

    I took the Criminologist licensure examination last December 14, 2021.


    (profession) (date)

    e to inform you of my health status as of December 29, 2021.


    (date)

    ndyl B. Torrigue
    nue:___________________________________
    319

    status is: (Please check () all relevant items)


    no symptom/s.
    h the following symptom/s:
    _ fever
    _ cough
    _ easy fatigability
    _ other signs/ symptoms or remarks: ___________

    pleting the message, you will receive an acknowledgment and/or further


    s from PRC.

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