St Pauls Hostel Safe Environment Visitor DeclarationForm No: 23.6.5 Covid19 Form Update 23.6.5Please enable JavaScript in your browser to complete this form.Full Name *Declare the following to be true on this *(Today's date)My temperature on entry reads *(Current temperature reading)In the last 7 days, I have not been in contact with a confirmed case of COVID 19 *TRUEFALSEI do not have COVID-19 Symptoms, which include but not limited to: *TRUEFALSE- a temperature of 37.5 degrees or higher - symptoms such as a cough, sore throat, shortness of breath, loss of smell or loss of tasteI am not currently required to self-isolate *TRUEFALSEPenalties apply for providing false information. If you have any symptoms, however mild, you must get tested and isolate until your test results are known.SUBMIT
