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Annex C

The document is a Post Examination Health Surveillance Form that requires candidates to report their health status 15 days after their licensure examination. It includes instructions to maintain social distancing and wear masks, along with a section for candidates to provide their name, testing venue, and health symptoms. The candidate, Jonalyn Catalan, confirms having no symptoms following the Architecture licensure exam taken on June 17 and 19, 2022.

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10 views1 page

Annex C

The document is a Post Examination Health Surveillance Form that requires candidates to report their health status 15 days after their licensure examination. It includes instructions to maintain social distancing and wear masks, along with a section for candidates to provide their name, testing venue, and health symptoms. The candidate, Jonalyn Catalan, confirms having no symptoms following the Architecture licensure exam taken on June 17 and 19, 2022.

Uploaded by

jonacatalan323
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Annex “C”

Post Examination Health Surveillance Form

Instructions: Please continue to follow social distancing and the wearing of face mask
even after the exam. You are required to send an email at the official email address of the
Regional Office where you take your licensure examination 15 days after the last
examination date. Please provide truthful information relative to your health status.

Dear PRC,

Good day! I took the ARCHITECTURE licensure examination last JUNE 17 & 19
(profession) (date)

I would like to inform you of my health status as of JUNE 28, 2022 .


(date)

Name:_____JONALYN CATALAN___________________
Testing Venue:___AYALA MALL MANILA BAY CINEMA 5
Room No: __CINEMA 5 GROUP 2
Seat No: __27_____

My health status is: (Please check () all relevant items)


___ have no symptom/s.
___ am with the following symptom/s:
___ fever
___ cough
___ easy fatigability
___ other signs/ symptoms or remarks: ___________

After completing the message, you will receive an acknowledgment and/or further
instructions from PRC.

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