COVID-19 Contact Tracing Form

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COVID-19 Contact Tracing Form

If you are going to the hospital to do the PCR test, you must bring your Rapid Test kit which shows positive, NHI card, and ARC card.
PCR-test Hospital suggestion: Taipei Municipal Wang Fang Hospital (don't need to make a reservation). Taipei City Hospital Renai Branch (need to make a reservation)

*Name:

*Date Of Symptom Onset:

*Date Of Positive PCR Confirmation:

*Student ID:

*Phone Number:

*Department:

*Accommodation:

Format (On-capus): Dorm 3, Room 101m
Format (Off-campus): No. 198, Sec. 1, Dunhua S. Rd., Da’an Dist., Taipei City

*Close Contacts:

Format: Student ID / Name / Mobile Number
If you stay in the on-campus dormitory, please list your roommates:
If you stay in off-campus housing, please only list your roommates/flatmates who are also studying at Taiwan Tech.

*On-Campus Travel Histories:

Format: Date (MM/DD) / Location (On-campus only) / Timing (If possible) / Classroom code (IB-402)
From 2 days before symptom onset (preferred) or positive PCR result onset date till the last day you were presented on the campus.
Indicate take-out or eat-in if you've visited cafeterias.
Must include all the classes or research lab you attended and the classroom code.

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