Do you have any of the following symptoms now or within the last 14 days: Cough, smell/taste impairment, fever, breathing difficulties, body aches, headaches, fatigue, sore throat, diarrhoea, and / or runny nose (even if your symptoms are mild)?

Have you been in contact with anyone who is suspected to have or/has been diagnosed with Covid-19 within the last 14 days?

I declare all information given above is true and accurate.