Health Checklist Form
David's Salon SM Annex
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Are you experiencing any of the following?
Sneezing/Runny or Stuffy Nose
Shortness of breath
NONE OF THE ABOVE
Have you recently been in contact with anyone who has tested positive for COVID-19?
By submitting this form, you allow David's Salon SM Annex branch to collect and process the data indicated herein for the purpose of effecting control of the Covid-19 infection.
Your personal information is protected by RA 10173, Data Privacy Act of 2012, and required by RA 11469, Bayanihan to Heal as One Act, to provide truthful information.
A copy of your responses will be emailed to the address you provided.
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