1、附件2：健康状况声明书 Health Declaration Form I (Full name: , Passport number: ) hereby declare that I have had none of the following situations in the 14 days immediately preceding the date on this Health Declaration Form:1. Being confirmed or suspected of COVID-19 infection by any medical institution;2. Run
2、ning a fever at or above 37.3C or showing respiratory symptoms;3. Coming into contact with confirmed or suspected COVID-19 cases;4. Coming into contact with patients with a fever or respiratory symptoms;5. Staying in a community or hotel reporting confirmed or suspected COVID-19 cases;6. At least tw
3、o persons in my office or family running a fever or showing respiratory symptoms;7. Taking medicine for fever or cold;8. Visiting public spaces like hospitals, theaters, restaurants and leisure facilities or taking part in group activities without taking protective measures like wearing a mask.I dec
4、lare the truthfulness and veracity of the statements above and the COVID-19 negative certificate I have provided. If any of the above-mentioned situations happens to me before leaving for China, I shall cancel the trip.I acknowledge and accept the responsibilities under this Declaration pursuant to
5、the relevant laws and regulations of the Peoples Republic of China should I conceal any health condition that might cause the spread of quarantinable infectious diseases or give rise to serious risks of such spread. Signature: Date: _/_/_(Day/Month/Year) To be completed by consular officers of the C
6、hinese Embassy or Consulate:The Chinese Embassy/Consulate has examined the COVID-19 negative certificate (No. , Issuance date: _/_/_) provided by the declarant. Used for the sole purpose of pre-boarding screening by airlines, this health declaration form is valid until _/_/_. Seal: Date: _/_/_(Day/Month/Year)1 / 1
