Guest Coronavirus (COVID-19) Health

Questionnaire
Dear Valued Guest,

We encourage all of our guests to complete this questionnaire on behalf of themselves and
household members they are travelling with, before leaving home for their stay. Upon
completion, kindly send to healthyvacation@magdalenagrand.com

For groups comprising people from multiple households, we encourage one questionnaire is
completed for each separate household, rather than one questionnaire for the whole group.

Guest
name(s): SHERRYL BOODRAM AND RAJIV HARRY

Check in date: 8/12/2020 Check out date: 11/12/2020

Phone number: Email: SHERRYLBOODRAM@GMAIL.COM

Are you, or a member of your household that you are travelling with
been tested in the last 14 days for coronavirus (COVID-19)? YES NO

Are you, or a member of your household that you are travelling with,
currently required to be in isolation because you have been diagnosed YES NO
with coronavirus (COVID-19)?

Have you, or a member of your household that you are travelling with,
been directed to a period of 14-day quarantine as a result of being a YES NO
close contact of someone with coronavirus (COVID-19)?

If you answered YES to either of the above questions, then the person required to be in isolation
should remain in isolation until you are released, or until their 14-day quarantine period is
complete.
If you answered NO to the above questions, proceed to the symptom checklist below.
Are you, or a member of your household that you are travelling with, experiencing these
symptoms?
Fever (If you have a thermometer, take your own temperature. You are
YES NO
considered to have a fever if above 37.5⁰C)
Chills YES NO
Cough YES NO
Sore throat YES NO
Shortness of breath YES NO
Runny nose YES NO
Loss of sense of smell YES NO
 Thank you for your co-operation.

If you answered YES to any of the above questions, then the person experiencing symptoms
should avoid travelling and remain at home. If you are currently travelling, the person
experiencing symptoms should return home, or if you cannot return home immediately, isolate
that person from others. The person experiencing symptoms should also get tested for
coronavirus (COVID-19).
.
If you answered NO to all the above questions, you can proceed with your travel arrangements
as planned.

If you develop symptoms, stay at home and seek further advice from the 24-hour coronavirus
hotline on 1 877 WELL (9355) or your general practitioner.

Thank you for your co-operation.

Sincerely,

Vinod Bajaj C.H.A

General Manager