Health Check

NOTICE: Richmonde Hotel Iloilo strictly implements a "NO FACE MASK, NO ENTRY" policy.
Wear your face mask at all times while inside the premises.

First Name

Middle Name

Last Name

Gender

Email Address

Contact Number

Birthdate

Nationality

Occupation

Civil Status

Present Address *

Stay Date Start

Stay Date End

Scanned Temperature (in celsius)*

°C

Foreign countries you have worked, visited, transited in the past fourteen (14) days *

Did you visit any hospital, clinic, or nursing home in the past fourteen (14) days? *

Have you been in contact with a suspected or confirmed SARS-COV (COVID-19) patient for the past fourteen (14) days? *

Do you have any household member/s, or close friend/s who have met a person currently having fever, cough and/or respiratory problems? *

Data Privacy Consent:

The information I have given is true, correct and complete. I understand that failure to answer any question or giving false answer can be penalized in accordance with law.

I voluntary and freely consent to the collection and sharing of the above personal information online in relation to Richmonde Hotel Iloilo COVID-19 internal protocols.

Please be advised that the above information shall only be used in relation to Richmonde Hotel Iloilo COVID-19 internal protocols in accordance with the Data Privacy Act. For any concerns, you may contact (63 33) 328 7888

BY CLICKING, YOU READ AND AGREED TO OUR TERMS AND DATA USE POLICY

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