Corona Virus Self-Assessment Form 

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • In last 14 days, have you ever experienced the following?

  • By submitting I hereby confirm that the information I have given above is true, and that I will comply with the terms and conditions outlined above. Further Action: If you or one of the member of the group having Body Temperature > 37.3’C or experiencing the corona symptoms as mentioned in the question no. 5, please contact our customer care member through phone no: +62 813-3707-1135 (available in whats app, sms or phone call) or through our email : client.indonesia@happytrailsasia.com