The Health Declaration Card Form is a critical document implemented in response to public health requirements and data privacy regulations in the Philippines. This form is essential for organizations to monitor and maintain public health safety while complying with the Department of Health's guidelines and the Data Privacy Act of 2012. It is typically used for health screening in various settings including workplaces, educational institutions, and public facilities. The form collects vital information such as personal details, current health status, travel history, and potential exposure to infectious diseases. It becomes particularly crucial during public health emergencies but also serves as a standard health monitoring tool in regular circumstances. The document must align with requirements set forth by Philippine health authorities and privacy regulations, making it a necessary tool for risk management and health safety compliance.
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1. Personal Information: Basic identification details including full name, date of birth, contact information, and government ID numbers
2. Contact Details: Current address, phone numbers, email, and emergency contact information
3. Travel History: Recent travel information including locations visited in the past 14 days
4. Health Status Declaration: Current health condition and presence of any symptoms
5. Exposure History: Information about potential exposure to infectious diseases or contact with infected individuals
6. Certification: Declaration of truth and accuracy of provided information, with signature and date
7. Data Privacy Notice: Statement on how the collected information will be used and protected under RA 10173
1. Vaccination Status: Section for recording COVID-19 and other relevant vaccination information - include when required by current health protocols
2. Quarantine History: Details of any recent quarantine or isolation periods - include during active public health emergencies
3. Medical History: Pre-existing conditions and regular medications - include for longer-term health monitoring situations
4. Workplace Information: Employment details and work location - include for corporate or workplace health monitoring
5. Travel Purpose: Reason for travel and intended destination - include for travel-related health screening
1. Symptom Checklist: Detailed list of symptoms to be checked by the declarant
2. Privacy Policy: Detailed explanation of data handling procedures and privacy protection measures
3. Contact Tracing Protocol: Information about the organization's contact tracing procedures
4. Health Guidelines: Current health and safety protocols that the declarant must acknowledge
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Healthcare
Education
Tourism and Hospitality
Transportation
Manufacturing
Retail
Financial Services
Government Services
Business Process Outsourcing
Construction
Events and Entertainment
Relevant Teams
Human Resources
Compliance
Health and Safety
Medical Services
Facilities Management
Data Privacy
Administration
Operations
Risk Management
Security
Legal
Quality Assurance
Relevant Roles
Human Resources Manager
Compliance Officer
Health and Safety Officer
Medical Officer
Facility Manager
Data Privacy Officer
Administrative Manager
Operations Manager
School Administrator
Hotel Manager
Factory Supervisor
Risk Management Officer
Corporate Secretary
Security Manager
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