NIMBB COVID-19 Case Report Form Logo
  • NIMBB COVID-19 Case Report Form

    Fill up this form if you are experiencing any COVID-19 symptoms, confirmed to be COVID-19 positive by RT-PCR or rapid antigen test, or a close contact of a confirmed COVID-19 positive case. For urgent concerns, please get in touch with the NIMBB Health Liaison Officer Mark Fran (09178180428).
  • Details of COVID-19 Symptoms

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  • Asymptomatic and confirmed to be COVID-19 positive

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  • Close contact of a confirmed COVID-19 positive case

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  • Other information

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  • Submit your response

    By clicking the submit button, I hereby certify that the information given is true, correct and complete. I understand that failure to answer any question or any falsified response may have serious consequences under RA 11332 or the Law on Reporting of Communicable Diseases. I also recognize that any personal information given in this form is protected by RA 10173 or the Data Privacy Act of 2012.
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