test visit form

test visit form

Visit

Self-declaration form:

Name:

E-mail:

Location for your visit:

Who to visit:

Date of visit: (dd/mm/yyyy)

I do not have covid-19 symptoms (cough, fever, wheezing).

In the last 10 days, I have not had close contact with other people with suspicion of or diagnosed Covid-19.

I commit to follow the health authorities' hygiene advice; good hand washing, coughing/sneezing in the elbow and keeping a distance of two meters during the entire stay at NOAH.

If you are human, leave this field blank.