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110-1學生旅遊史與接觸史調查
1. 依教育局公告之防疫教育總指引辦理。
2. 請同學填報自調查日回溯14日,是否曾有國外旅遊史或與確診者接觸的情形。
3. 已配合導師調查者,不需重複填表單。
4. 請在8/31回報完成。
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110學年度 班級(Ex:101)
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座號
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姓名
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自填表日回溯14日,是否曾有「國外旅遊史」?
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是
否
自填表日回溯14日,是否曾有「與COVID-19確診者接觸」?
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是
否
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