Personal Pre-Screening
	ID / Passport number Name Surname Mobile number Email address
[Yes] or [No ]	Complete the following questions by selecting the relevant option
	Have you experienced a new loss of taste or smell in the last 14 days?
	Have you had a sore throat in the last 14 days?
	Have you had a rash on your skin, or discolouration of fingers or toes in the last 14 days?
	Have you traveled outside of the country in the last 14 days?
	Have you experienced persistent tiredness in the last 14 days?
	Have you had close contact with or cared for someone diagnosed with COVID-19 within the last 14 days?
	Do you sanitize your hands regularly?
	Have you had conjunctivitis (Intensely red eyes, watery discharge from the eyes, swollen eyelids and light sensitivity) in the last 14 days?
	Have you experienced loss of speech or movement in the last 14 days?
	Have you had diarrhea in the last 14 days?
	Have you experienced aches and pains in the last 14 days?
	Have you experienced Coughing up of blood or blood-stained mucus in the last 14 days?
	Have you experienced difficulty breathing or shortness of breath in the last 14 days?
	Have you had a persistent headache in the last 14 days?
	Do you have or have you had a Fever of > 37.3 Degrees Celsius or more in the last 14 days?
	Have your body temperature been taken or will it be taken today?
	Have you experienced chest pain or pressure in the last 14 days?
	Have you had a persistent dry cough in the last 14 days?
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