Professional Documents
Culture Documents
ARRIVING CREW
Name:
Vessel:
Position
Address
Body Temperature:
Date:
Time Taken:
Yes No
Have you received information and guidance on the COVID-19, including about
standard health protection measures and precautions?
Do you understand and comply with applicable standard health protection measures
and precautions to prevent the spread of the COVID-19, such as proper hand
washing, coughing etiquette, appropriate social distancing?
During the last 14 days, have you:
Tested positive for being infected with the COVID-19?
Tested positive for the antibodies for the COVID-19?
Shown any symptoms associated with the COVID-19, specifically
Sore throat:
Coughs and Colds:
Body Pains:
Headache:
Fever:
Completed a period of self-isolation related to the COVID-19?
If "Yes", please explain the circumstances and the length of self-isolation:
________________________________________________________________
Had close contact with anyone that has tested positive for COVID-19?
Had close contact with someone with symptoms of the COVID-19 among your
household or in your community?
Maintained good personal hygiene and complied with applicable health protection
measures and precautions?
I attest that I have voluntarily and truthfully provided all the above information.
______________________________________________________________
Name /Signature
Certified by:
___________________________________________________
Master Name / Signature / Date
Please send copy of this form to your respective fleet within 24-hours prior your joining date
Instruction:
a. Original Form to be presented onboard
b. Photocopy or send a copy to your fleet
MMC-PROTOCOLCOVIDGUIDELINE0502-02-1
Name:
Vessel:
Position
Please record your body temperature twice a day (AM and PM) upon receipt of vessel assignment notification up
to your joining date.
___________________________________________________
Name /Signature
Certified by:
___________________________________________________
Master Name / Signature / Date
Instruction:
a. Original Form to be presented
b. Photocopy or send a copy to your fleet