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UNIVERSITY OF THE PHILIPPINES Diliman, Quezon City HEALTH CHECKLIST FOR FACULTY/STAFF RE-ENTRY
To be able to monitor and control the spread of COVID-19 infection within the campus, the faculty and staff are requested to accomplish this health checklist every time they re-enter their workplace. The university ensures that any sensitive personal information contained herein shall be kept confidential and protected under the Data Privacy Act of 2012. If needed, information from this health checklist may be used to facilitate contact tracing efforts by the University Health Service Public Health Unit (UHS-PHU) and/or the Local Government Unit (LGU).
Name *
Email Address *
Contact number *
College/Unit:
Department/Institute:
Body Temperature
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