CUHK Business School Career Fair 2021 Health Declaration

We appreciate if you could fill in this health declaration form and submit to Career Management Centre before joining our Career Fair on 13 March.

Thank you for your continuous support to CMC. We look forward to seeing you in the Career Fair!

Guest Name
Company name
Email
Date of visit Date of visit / MM / DD YYYY

Please answer the following questions:
Please answer the following questions:	Yes	No
Have you had fever, malaise, cough, shortness of breath or other flu-like symptoms within past 14 days?	Have you had fever, malaise, cough, shortness of breath or other flu-like symptoms within past 14 days?Yes	Have you had fever, malaise, cough, shortness of breath or other flu-like symptoms within past 14 days?No
Have you travelled out of Hong Kong within past 14 days?	Have you travelled out of Hong Kong within past 14 days?Yes	Have you travelled out of Hong Kong within past 14 days?No
Have you had close contact with any person who has travelled out ofHong Kong within past 14 days, in particular family members or helpers?	Have you had close contact with any person who has travelled out ofHong Kong within past 14 days, in particular family members or helpers?Yes	Have you had close contact with any person who has travelled out ofHong Kong within past 14 days, in particular family members or helpers?No
Have you had close contact with any person who has tested positive with COVID-19 within past 14 days?	Have you had close contact with any person who has tested positive with COVID-19 within past 14 days?Yes	Have you had close contact with any person who has tested positive with COVID-19 within past 14 days?No

I hereby confirm that I have fully read and understood the above questions and answered them truthfully.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Disclaimer The personal data collected will be used by Career Development and Corporate Engagement Office and authorised personnel for processing the captioned purposes in accordance with relevant provisions of the Personal Data (Privacy) Ordinance.