Collect Specimen Date
Deep Throat Saliva
Chan Tai Man
Chinese First Name
Date of Birth
ID Document Type 1
ID Document No 1
ID Document Type 2
ID Document No 2
Country / Region Code
Mobile Phone Number
1. Are you currently experiencing, or have you experienced a fever within the past 14 days?
2. In the past 14 days, have you travelled outside of Hong Kong?
2020/09/10 - 2020/09/15
3. Is your occupation healthcare or medical related?
4. In the past 14 days, have you been in close proximity with any cluster diagnosed with having COVID-19?
5. In the past 14 days, have you been in close proximity with anyone diagnosed with having COVID-19?
6. Are you travelling to Mainland China or Macau?