Preventive Health Care Declaration
No. 3
Due to the Coronavirus outbreak, our school leadership has put in place several measures which include that all visits to
our campus can only take place after the signing of this declaration. Please see also “Guidelines for prevention health
care measures at IMZ in response to COVID-19”, Guidelines base on the recommendations of the BAG, BSA and WHO.
We thank you for helping us ensure the safety of our community.
Date of visit
Reason for the visit
First & last name
Phone
Email
Confirmation
By signing this form, you hereby declare that you and your family members:
Have not visited risk areas in the past two weeks.
Have not been in close contact with people who have been in risk areas in the past two weeks.
Date
Signature
click to sign
signature
click to edit
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