COVID-19 Health Declaration Form
Psychology Blossom seeks your co-operation to complete the following form to facilitate contact tracing, if and when necessary, given the ongoing Covid-19 pandemic.
Please note that any person returning a temperature reading at or above 37.5°C or has answered "Yes" to the questions above will not be allowed to enter the clinic. This is for the health and safety of all occupants of the building.
By providing personal data through this declaration form, you authorise us to collect, use, process and disclose personal data provided for the purpose of verifying your identity, screening your health status and maintaining records of visitors to Psychology Blossom for contact tracing purposes, to ensure our safety and security. Thank you for doing your part in keeping Singapore safe.