Dear Guest

Namaskaram!!!!

The hospitality industry has been requested by the Government officials to be aware of the travel details of their guests since 31st January 2020. This will help and assist the authorities to track, manage & control any occurrence of the sickness that may be related to COVID 19. Kindly cooperate with us by filling this declaration form. This information will be shared with the health / tourism officials only.

Regards
Rahul Tom
Managing Director

    Forehead Temperature

    Date of Arrival in India

    Date of Departure from India

    Check-In Date

    Check-Out Date

    All questions are compulsory

    Are you unwell/experiencing symptoms like cough, cold, sore throat, fever, breathing difficulty?

    Have you been in close contact with anyone suspected / suffering from COVID 19?

    Have you ever visited a hospital where COVID 19 cases were being treated?

    Are you unwell/experiencing symptoms like cough, cold, sore throat, fever, breathing difficulty?

    Have you been in contact with body fluids of a known COVID 19 patient? (Respiratory Tract Secretions, Blood, Vomitus, Saliva, Urine, Facces)

    Have you had direct physical contact with the body of a patient including physical examination?

    Have you come in contact (touched or cleaned) the linen, clothes or dishes of the patient?

    Have you ever come in close proximity(3 feet or 1 Metre) of a confirmed patient for an extended period of time?

    Have you ever shared the same (Class Room or Work Space) , etc. with confirmed or suspected case ?

    Have you ever travelled (Bus, Train, Flight)/ stayed (Hotel/Cruise) in the same environment with confirmed or suspected case if COVID 19, but did not have any direct exposure?

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