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Pescados Customer Covid-19 Healthcheck
 

 

 

 

  * Fields are mandatory
  * Please complete the fields below:
     
  Name:
  Surname:
  Email:
  Contact Number:
  Date:
  Time:
  Temperature:
 
     
  Please complete the fields below:
     
  ID/PASSPORT NO:
  NATIONALITY:
     
  Are you experiencing any of the following symptoms?
     
  Fever/Chills
  Shortness of Breath
  Cough
  Body Aches
  Loss of Taste or Smell
  Redness of Eyes
  Nausea/Vomiting/Diarrhoea
  Fatigue/Weakness/Tiredness
  Had contact with anyone who has tested positive within the last 24hours
  Have you been exposed to someone who has had covid in the last 14 days
     
  * I confirm that I have not experienced any of the symptoms listed above
     
  Yes, I have
  No, I have not
   
  * I confirm that I have not been in contact with anyone who has tested positive for covid within the last 14 days:
     
  Yes, I have
  No, I have not
   
  * Please enter total number of guests in the Text Box below:
 
   
 


 
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