Visitor Form

As part of our health and safety measures in helping to prevent the spread of COVID-19, we are collecting your contact number should you be exposed to a person who may be infected during your time at our office. Thank you for your cooperation.

Personal Data

Full Name*

Mobile Number*

Person to Visit*

Reason of Visit*

Temperature*

By submitting this form, I declare that:

I have not had any close contact with confirmed COVID-19 cases in the past 14 days.*

I am not serving a self-quarantine notice*

I do not have any flu-like symptoms and/or fever*

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