Workplace Post-Quarantine Reentry Declaration Form
Employee Information
Full Name
Employee ID
Department
Contact Number
Quarantine Details
Quarantine Start Date
Quarantine End Date
Quarantine Location
Health Declaration
I am not experiencing any symptoms such as fever, cough, or difficulty breathing.
I have not been in close contact with anyone confirmed positive for COVID-19 in the last 14 days.
I have completed the required quarantine period and have been cleared by the relevant health authorities.
Other relevant information (optional)
Employee Declaration
I hereby declare that the information provided above is true and complete to the best of my knowledge.
Date
Signature