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    Covid-19 Health Declaration

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    dushyant
    This document is a COVID-19 self-health declaration form for trainees of the Aviation Security Training Institute. It contains checkboxes for the trainee to indicate if they have experienced COVID-19 symptoms, been exposed to the virus, or traveled from affected areas. The trainee agrees to follow health protocols and contact authorities if symptoms develop. They also acknowledge liability for penalties if training is undertaken when eligibility criteria are not met.

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    Download as DOC, PDF, TXT or read online from Scribd

    Covid-19 Health Declaration

    Uploaded by

    dushyant
    29 views1 page
    This document is a COVID-19 self-health declaration form for trainees of the Aviation Security Training Institute. It contains checkboxes for the trainee to indicate if they have experienced COVID-19 symptoms, been exposed to the virus, or traveled from affected areas. The trainee agrees to follow health protocols and contact authorities if symptoms develop. They also acknowledge liability for penalties if training is undertaken when eligibility criteria are not met.

    Original Title

    Covid-19 Health Declaration (1) (1)

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    This document is a COVID-19 self-health declaration form for trainees of the Aviation Security Training Institute. It contains checkboxes for the trainee to indicate if they have experienced COVID-19 symptoms, been exposed to the virus, or traveled from affected areas. The trainee agrees to follow health protocols and contact authorities if symptoms develop. They also acknowledge liability for penalties if training is undertaken when eligibility criteria are not met.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    29 views1 page

    Covid-19 Health Declaration

    Uploaded by

    dushyant
    This document is a COVID-19 self-health declaration form for trainees of the Aviation Security Training Institute. It contains checkboxes for the trainee to indicate if they have experienced COVID-19 symptoms, been exposed to the virus, or traveled from affected areas. The trainee agrees to follow health protocols and contact authorities if symptoms develop. They also acknowledge liability for penalties if training is undertaken when eligibility criteria are not met.

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    DIAL Aviation Security Training Institute

    Date - _________
    COVID-19 SELF HEALTH DECLARATION
    (TO BE FILLED UP BY THE TRAINEE IN CAPITAL LETTERS)
    Trainee Name: ____________________________________ Emp ID __________________
    Organization Name: _______________________________ Designation _____________________
    Place of Duty: ____________________________________ Mob No: __________________

    Tick wherever applicable Yes/No Yes/No


    Does your current residential address fall I am/we are not suffering from any of following
    under active containment zone as declared A. Fever
    by Government Authorities? B. Loss of senses of smell and taste
    C. Cough
    D. Respiratory distress.

    Have you/family/room mate or anyone with If I/We develop any of the above mentioned
    whom you are staiying been under home Symptoms. I/We shall contact the concerned
    quarantine as advised by local health authority? Health authorities immediately.

    Did you or someone in your family or the one Have you ever had Diabetes/Hypertension/
    with whom you are staying come in close Lung disease/Kidney Disorder/heart disease.
    contact with a confirmed COVID-19 patient in
    the last 14 days.

    Have you or soemone in your close I understand that if I undertake the training
    family returned from a foreign county,in Without meeting the eligible criteria. I would
    the last 1 month? Be liable for penal action.

    I/We undertake to adhere to the health Complete Residential Address of Trainee –


    Protocol prescribed by the authorities.

    I shall make my mobile number contact


    details avilable to the academy whenever _______________________________________________
    required by them. It is hereby declared that declaration given by trainee is
    correct.

    Have you downlaoded Arogya Setu App. Authorized Signatory of the Company

    Name –
    During AVSEC Course, Incase of any symptoms of
    COVID-19 found then the ASTI will take appropriate Designation –
    action
    Signature –

    _________________________

    Employee Signature

    DIAL-ASTI
    DIAL ASTI, IGI AIRPORT, Terminal-2, NEW DELHI-110037

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