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SIRI HERITAGE BANGKOK HOTEL

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Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

Email

Age

Nationality

My body temperature is lower than 98.6°F/ 37.5°C

I am not experiencing the symptoms: fever, cough, sore throat

I haven’t been in close contact with a Covid-19 patient in the last 14 days

Initials

Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

SIRI HERITAGE HOTEL BANGKOK

10 Trok Siri Ammat, Boonsiri Road,

San Chao Pho Sua, Phra Nakhon,

Bangkok, 10200 Thailand

CONTACTS: +662-2240095

+669-28850095

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