Contact tracing

Contact tracing due to COVID-19

Name*
Name insertion Last name
Phone number*
Date of visit Dolfinarium*
DD slash MM slash YYYY
Health Screening*
Have you had one or more of the following (mild) complaints in the past 24 hours: nose cold, cough, chest tightness or fever (from 38 degrees Celsius)?

Do you currently have a housemate or family member with a fever or shortness of breath?

Have you had COVID-19 (determined by a lab test) and has it been diagnosed within the past fourteen days?

Have you been in contact with someone who has been diagnosed with or has symptoms of COVID-19 in the past fourteen days?

Have you, or someone in your household, been in a country or region for at least 48 hours in the last fourteen days with a negative travel advice due to corona (code red)?

If you answer “yes” to one of the above questions, then unfortunately you cannot visit our park at the moment. In this case, you must contact [email protected] to have your tickets rebooked for a new visit date.

I declare that I have answered the above questions truthfully.
Permission*
I give permission to the Dolfinarium to temporarily store my data for a possible contact tracing of the GGD. The data is kept for a maximum of 14 days. After this, the data will be destroyed.