COVID-19 - HEALTH DECLARATION
To control the COVID-19 outbreak and in line with the Restriction Movement Order, the Ministry of Higher Education Malaysia has on 18th March 2020 instructed all local and international students to remain in their current residence until 31st March 2020.
Students are to remain in their current residence and are not allowed to travel home, both interstate or overseas. Leave your residence only when necessary, such as to buy food and other essentials. When you are out, please ensure that you take the necessary precautions and practice social distancing. Stay one meter (3-feet which is approximately the width of a door) apart from the other person. This mindful practice will reduce the spread of the virus.
The Student Health Self-Declaration Form (COVID-19) is meant to document your current residence and your health status.
Nilai University collects, uses and destroys personal information in accordance with the Personal Data Protection Act (PDPA) 2010.
Name: (Full name as per IC or Passport)
SECTION A: RESIDENTIAL INFORMATION
1.Where are you currently staying during the Restricted Movement Order ?
Nilai University on campus accommodation
Out of campus accommodation (Rented room / apartment / house)
Home with family / relatives
2.Please provide your current residence address
SECTION B: HEALTH DECLARATION
1.Have you travelled overseas in the past 14 days?
Name of Country
Date returned to Malaysia
If your answer is Yes, you will need to be self-quarantined for 14 days from date of return to Malaysia. Please stay at home. If you develop symptoms (fever / coughing / difficulty in breathing), please seek medical attention at the nearest government hospital.
2.Have you been in close contact with a confirmed case of CoVid-19?
If your option is 'YES' choose one of the option from Dropdown list
I had visited a COVID-19 patient in the hospital/home.
I was in close proximity with a Covid19 patient
I travelled together with COVID-19 patient in any kind of conveyance
I am currently living in the same household as a COVID-19 patient
If your answer is Yes, you will need to be self-quarantined for 14 days from date of contact. Please stay at home. If you develop symptoms (fever / coughing / difficulty in breathing), please seek medical attention at the nearest government hospital.
3.Have you been tested positive for CoVid-19?
If your answer is 'Yes', please abide strictly to the advice given by the medical or government authorities. You must inform the University immediately by emailing to the Registrar ( email : firstname.lastname@example.org)
COVID-19 - BEST PRACTICES DURING THIS TIME
- Stay at home
- Practice Social Distancing (stay 1 metre apart from the next person) when you need to go out
- Avoid crowded places and close contact with people who are unwell
- Practice good hygiene and wash your hands often with soap, especially before handling food, after coughing or sneezing,
and after using public facilities
- Avoid touching your face
- Wear a mask if you have any respiratory symptoms such as coughing or sneezing
- Boost your immunity by eating and sleeping well
- Seek medical attention immediately if you are feeling unwell or having any of the respiratory symptoms
Nilai University seeks your kind understanding and cooperation in following the measures that the University is taking, which are based on guidelines and recommendations from the Malaysian Ministry of Health, Malaysian Ministry of Education and the World Health Organization (WHO).
We thank you for your cooperation and flexibility in the temporary changes we are making to protect the health and wellbeing of our community, and for looking out for each other during this time.
Stay safe and keep well.
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