RAJAVITHI HOSPITAL , Bangkok Thailand

Risk assessment form before hospital visit for CORONA VIRUS 2019 infection
ภาษาไทย || 中文 || English || 日本

Please answer the questions truthfully

14 days before , Did you have any risk below ?

This self assessment tool is for encouraging people to be more aware of their self protection from health risks and reducing unnecessary hospital visits

1 : You have stayed or came from China ( every province including Hongkong , Macao and Taiwan ), Japan , Singapore, South Korea , Italy and Iran
2 : your work was closely contacting with the traveler who came from china ( every province including Hongkong , Macao and Taiwan ), Japan , Singapore, South Korea , Italy and Iran 3 : You have closely exposed to patient who confirmly infected by Corona virus 2019