Questionnaire for patients with fever and common cold symptoms
※Be sure to CHECK the □ above.
Please follow the procedure in the order of ①to②.
Please send us photos of your health insurance card and medical ticket.
※ Medical tickets : only to those who have them.
Please fill out all the forms below and press SEND.
※ There is an obligation to report your occupation to health center if you are tested POSITIVE.
What is your symptom and problem
Thank you for sending your information.