Aide Code / 護理編號:
Last 4 Digit Social Security Number / 社安號最後4位:
Do you have any of the following / 你有沒有以下任何一項:
Yes / 有No / 沒有
我清楚並且同意如果有任何變化, 有任何疑似新冠病徵，或接觸過確診的人, 會立刻隔離自己並且跟公司聯絡 / I understand and attest that if there are any changes to my health condition, if I experience any of the COVID-19 related symptoms, or if I have had contact with someone who tested positive for COVID-19, I will isolate myself and notify Golden Touch immediately.
I agree / 我同意