Guest Covid-19 Questionnaire
We appreciate that we are asking for more detailed information than usual. This information is to ensure we can address appropriately any risks should you or one of our guests or staff become ill with suspected COVID-19, and ensure that in such an event, the required contact tracing can be carried out. All information provided will only be shared with authorised persons.
NOTE: As per the regulations to the Disaster Management Act, 2002 published on 17 March 2020, any person who intentionally -
1. Misrepresents that he/she/any other person is infected with COVID-19 is guilty of an offence and on conviction can be fined and/or imprisoned (for up to 6 months)
2. Exposes another person to COVID-19 may be prosecuted for an offence, including assault, attempted murder or murder.
HEALTH QUESTIONS:
Are you feeling well?
Yes No
Do you have a cough
Yes No
Do you have a fever or chills
yes No
Do you have a sore throat
Yes No
Do you have shortness of breath
Yes No
In the last 14 days, to your knowledge, have you been in close contact with anyone who tested positive for COVID-19 or is awaiting a test result?
Yes No
Have you attended or visited a healthcare facility treating patients with COVID-19?
Yes No
Are you awaiting the results of a Covid-19 test?
Yes No
Have you traveled internationally in the last 30 days?
If yes:
Which countries have you visited
Dates
Which country did you return to South Africa from
Dates
Temperature reading on Check In
I, hereby confirm that all the information provided is accurate. Failing this, I agree to vacate the unit immediately and forfeit the accommodation rental fee.
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