Crew Health Declaration
Personal Details
Full Name
Crew ID / Staff Number
Position
Nationality
Health Status
Have you experienced any of the following symptoms in the last 14 days? (e.g. fever, cough, difficulty breathing)
Have you been in close contact with anyone diagnosed with an infectious disease (including COVID-19) in the last 14 days?
No
Yes
Do you have any existing chronic illnesses or medical conditions?
Recent Travel
Countries visited in the last 14 days
Declaration
I hereby declare that the information provided above is true and correct to the best of my knowledge.
Date
Signature