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Travel Declaration Form
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Email address *
FULL NAME *
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CONTACT NUMBER: *
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SCREENED BODY TEMPERATURE:
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PLEASE INDICATE IF YOU HAVE:
Have been in close contact with any confirmed case/s of COVID-19 in the last 14 days, please provide details: *
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If you have travelled outside Singapore in the last 14 days, please provide the details and country: *
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I hereby declare that I have answered the above questions truthfully and to the best of my knowledge. *
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I agree to inform the management of Le Bistrot du Sommelier if myself &/ close contact/s is/are with Leave of Absence/Stay Home Notice/Quarantine Order by MOH. *
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