COVID-19 Health Status & Travel Declaration 健康状况和旅行动态申报

I commit that I will report the requested information timely and truthfully. If here are any changes, I will update the declaration timely. I commit that I will follow all the preventive measures and instructions from government and FRCCA office, including but not limited to the released local specific COVID-19 prevention and control Measures. I will proactively implement the protection measures, and try the best to protect myself, the colleagues. I commit that if myself, my families, colleagues, or friends, anyone who has the sensitive/concerned symptoms and travel histories, I will report it accordingly and take self-quarantine measures at once, and seek for medical care.
我承诺及时、如实汇报；任何变化将第一时间更新申报信息。我承诺我将遵守地方及公司的所有预防措施，包括但不限于具体现场发布的抗击新型冠状病毒肺炎防控措施。我承诺积极做好各项防护，尽最大努力保护自己、同事。我承诺自己、家人、同事或朋友如果出现任何症状或须报告的旅行记录，我将立即报告并采取隔离措施，并寻求医疗救护。
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Your name
您的姓名：
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Please select the places you travel back Shanghai from
请选择您返回上海前所在的省份城市与地区:
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purpose of this declaration
本次申报的类型
返沪返岗前申报 after back Shanghai before back to office
其他（请详述）Others (please specify)
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Please specify other purpose for the declaration
请详述其他的申报原因
If here are concerned answers to questions below, please don't come back to office or stop/postpone the travel, report to your superior timely, and report to local authorities accordingly and seek for the medical advise asap.
如果您的答案跟疫情关注的管控有关，请取消返回FRCCA办公室或者相关的差旅安排，及时报告您的主管，并按照地方要求进行报告，尽快寻求专业医疗建议。
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Have you or your close contacts (families/friends. etc.) ever traveled by flight or train in previous 14 days (incl. the planned arrival date to FRCCA office)? 
您或您的密切接触人员（家人、朋友等）过去14天（包括计划抵达FRCCA办公室当天）是否乘坐飞机或者火车或其他公共交通出行往返上海？
Yes 是
NO 否
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Have you or your close contacts (families/friends. etc.) ever stayed or stopped at or passed by any cities/districts with COVID-19 high risk and middle risk areas (incl. the planned arrival date to FRCCA office)? 
您或您的密切接触人员（家人、朋友等）过去14天（包括计划抵达FRCCA办公室当天）是否曾经去过、停留、途径中、高风险疫情区域的市/县/区（包含该区域的低风险位置）？
Yes 是
NO 否
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Health status of you and your close contacts (families, friends, etc.)
您以及您的其他密切接触人员（家人、朋友等）的健康状况确认
Yes 是NO 否
be COVID-19 confirmed case 当前是否被确诊为新型冠状病毒肺炎
be COVID-19 confirmed case 当前是否被确诊为新型冠状病毒肺炎
be suspected and to be verified 当前是否出现新型冠状病毒肺炎疑似症状，正待医院确认
be suspected and to be verified 当前是否出现新型冠状病毒肺炎疑似症状，正待医院确认
with symptom of fever, weak, coughing, sneezing or other respiratory symptoms 当前是否出现发热、乏力、咳嗽、打喷嚏或其他呼吸道症状
with symptom of fever, weak, coughing, sneezing or other respiratory symptoms 当前是否出现发热、乏力、咳嗽、打喷嚏或其他呼吸道症状
temperature 当前体温是否正常 （低于37.2℃）
temperature 当前体温是否正常 （低于37.2℃）
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What's your current color of the online "Health cloud” in Shanghai?
您当前“随申码”的颜色是什么？
Red 红色
Yellow 黄色
Green 绿色
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Please list the recorded travel itinerary according to your travel card, incl. previous 14 days.
请根据您的“通信大数据行程卡”显示的信息提交过去14天您到达或途径的地点。
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