Covid-19 Test Results Declaration Form

Note:
As part of MCAS’s rostered routine testing, all persons entering MCAS Premises must have taken an ART/PCR test with negative results in the last 7 days.

If any ART/PCR test taken within the last 7 days is positive, please inform the person in charge of the project immediately. If you are a staff, please inform CA/HR.

Please fill up this form ONLY AFTER you have completed your ART test.

Check your email and show the approval to Security / Screening Officer at our entrance. You are required to strictly adhere to prevailing MOH protocols and instruction of our SafeEntry Screening Officers at MCAS entrances.

USE OF DATA
Data submitted will be kept for 30 days and strictly for processing of gaining entry to MCAS premise and may be provided to the authorities for contact tracing upon requests.

Full Name (Per NRIC/Passport/FIN): *

Phone *

Email *

Date of test *

Date / Time of Entry to MCAS *

Date

Time

Must be within 7 days of the ART test

Purpose of Entry *

ART Result: *

• I have done an ART in the last 7 days and the result is NEGATIVE.
• I have done an ART in the last 7 days and the result is POSITIVE.
• I am exempted from ART testing.

Upload your negative ART kit showing only your name and date. DO NOT UPLOAD WITH YOUR NRIC/FIN/Passport *

Click or drag a file to this area to upload.

Declaration: (NEGATIVE) *

• I have done the ART in the last 7 days and the result is NEGATIVE, and I confirm the following: I am not tested positive for Covid-19 (either ART/PCR) in the last 72 hours. I am NOT subjected to any MOH quarantine or any other order.
• I will not enter any MCAS premises or participate in any on-location assignment if I have tested ART positive in the last 72 hours or if I am a subject of any MOH quarantine or other isolation order.
• All information provided are true, complete and accurate and I allow the information provided in this form to be used for health and safety purposes.

Declaration: (POSITIVE) *

• I have done an ART in the last 7 days and the result is positive, and I confirm the following: I am aware that I have to comply with prevailing MOH protocol and to self-isolate. I will not to enter any MCAS premises or participate in any on-location assignment until I have obtained a subsequent negative ART test (taken at least 72 hours later). All information provided are true, complete and accurate and I allow the information provided in this form to be used for health and safety purposes.

Reason for exemption:

• I have done a PCR test in the last 7 days and the result is negative
• I am on the Government’s Fast and Easy Testing Regime and the result is negative
• Exempted by MOH
• Medically excused by doctor (with doctor’s letter given to Supervisor/HR)

Declaration: (EXEMPTED) *

• I am exempted from ART by MOH, and I confirm the following: I am NOT subjected to any MOH quarantine or any other isolation order. I will not enter any MCAS premises or participate in any on-location assignment if I am a subject of any MOH quarantine or isolation order. All information provided are true, complete and accurate and I allow the information provided in this form to be used for health and safety purposes

Submit