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Quarantine Declaration Form
"I need a Quarantine Declaration Form for our medical facility in Singapore that will be used for international travelers arriving from high-risk countries, with specific provisions for digital temperature monitoring and remote health check-ins starting from March 2025."
1. Personal Information: Collection of declarant's details including full name, NRIC/FIN/Passport number, date of birth, contact number, email and residential address
2. Travel History: Details of recent travel including countries visited, dates, and transit points in the last 14 days
3. Health Declaration: Current health status, symPTOms checklist, and existing medical conditions that may be relevant
4. Quarantine Acknowledgment: Details of quarantine location, duration, and start/end dates, including acknowledgment of understanding
5. Legal Declaration: Formal declaration of truth and accuracy of provided information, acknowledgment of legal obligations and penalties for non-compliance
1. Vaccination Status: Details of COVID-19 or other relevant vaccination history, required during active disease outbreaks
2. Close Contact Information: Details of recent close contacts for contact tracing purposes, required during active disease surveillance
3. Special Assistance Requirements: Declaration of any medical, dietary, or personal assistance needed during quarantine period
4. Employment Details: Information about current employer and workplace, required for working persons who may need work-from-home arrangements
1. Schedule A - Quarantine Guidelines: Detailed instructions for quarantine compliance including dos and don'ts
2. Schedule B - Emergency Contact List: List of important contact numbers including medical facilities, quarantine officers, and helplines
3. Schedule C - Health Monitoring Form: Template for daily temperature recording and symPTOm monitoring
4. Schedule D - Penalties and Offences: Detailed list of offences and corresponding penalties under relevant legislation
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