國立中正大學 校園嚴重特殊傳染性肺炎 健康關懷問卷-校外人士 National Chung Cheng University Campus COVID-19 Health Care Survey-This survey is for extramural visitors who participated in the activities or business
您好:
為因應「嚴重特殊傳染性肺炎」疫情,請協助我們填寫下列資料,並詳細閱讀注意事項,於本校活動期間配合以下防疫措施:

1.請落實發燒不上班不上課。請戴口罩進入校園,進入校園及各棟大樓請配合體溫量測,倘若出現發燒(耳溫≧38
℃)請立即佩戴口罩,離校就醫,就醫時,請主動告知醫師旅遊史、接觸史及居住史。如有呼吸道症狀(咳嗽、喉嚨痛、呼吸道窘迫症狀、流鼻水等),亦請全日佩戴口罩。

2. 維持手部清潔,保持經常洗手習慣,原則上可使用肥皂和清水或酒精性乾洗手液進行手部衛生。儘量不要用手直接碰觸眼睛、鼻子和嘴巴。

國立中正大學衛生保健組 敬啟

Dear Sir or Madam,
In response to the COVID-19 outbreak, CCU prepared a survey for you as we really care about your health, and we believe well preparation can bring us through the pandemic. Please fill in the following information and read the notice carefully. Wish you good health and happiness.

1.Carry out not to attend work and class if having a fever. Please wear a mask in the campus and enter the buildings with temperature measurement. If you get a fever (temperature above 38℃) please immediately wear face mask and leave school for medical treatment. Please inform the doctor of travel, exposure and residence history automatically.

2.Keep your hands clean and wash your hands regularly. Use soap or alcohol hand sanitizer for hand hygiene. Try not to touch your eyes, nose and mouth directly with your hands.
Email address *
姓名 Name *
性別 Sex *
出生年份(請填寫西元年,例如:1970) Year of Birth *
所屬(或受邀來訪)之系所/單位 (Invited)Department/Unit *
校外單位/公司名稱 Extramural Unit/Company *
前來本校參與之活動或公務名稱 Name of the event or business participated in CCU *
於本校參與活動或公務期程 Date of the event or business participated in CCU(範例 For Example:2020/03/20~2020/03/25) *
手機 Phone Number *
請問您2020年是否自其他國家入境台灣? Have you entered Taiwan from abroad in 2020? *
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