Travel and Health Declaration for Visitor

To create a new travel and health declaration, simply fill in the required information below and click on the Submit button.

If you have been to other countries besides Singapore in the last 14 days, we require that you postpone your visit/meeting to our campus for at least 2 weeks.

The completed form must be filled on the day of the visit.

We may also use the information provided for the purpose of contact tracing should there be a need to do so. Please note that the data collected will be disposed at an appropriate time.

Name of visitor*:

Organization Name:

Email*:

Mobile Number:

Date of Visit to SUTD *:

Purpose of Visit *:

Visiting whom in SUTD(Email Id)*:

1. Have you travelled to other countries besides Singapore in the past 14 days?
-Please state countries visited:
(To add multiple countries, use comma(,) as separator)
2. Have you received a Quarantine or Isolation Order, or Stay-Home Notice in the past 14 days?
      
3. Within the past 14 days have you been in close contact with someone who is a confirmed case for COVID-19 or has been placed on Quarantine or Isolation Order, and/or served Stay-Home Notice?
      
4. Have you been issued a medical certificate (MC) for respiratory symptoms and the validity date of the MC has not yet expired?
      
5. Are you unwell with one or more of the following symptoms?
                                                
            
If you have indicated YES to any of the above questions, or ticked any of the boxes for Q5, we require that you postpone your visit/meeting to our campus for at least 2 weeks.

Consent and Declaration

By providing these details, I hereby give consent to the event organizers to use the information for the reasons stated above. I declare that the information provided in this questionnaire is true to the best of my knowledge.