Free Contactless Digital COVID Screening Form

Keep Corona virus out of your workspace!

Customers and visitors will complete a health self-declaration QR code form at your establishment entries, to help prevent COVID-19 spread.

This free platform has been built based on the DOH and DTI guidelines. Our only interest is to help stop the spread.

    Get your FREE digital screening form. Simply fill out the form below!

    Acceptable File Types: jpg, png, pdf

    How the Contactless Digital COVID Screening Form works

    1. Sign-up for free 
      Fill out the sign-up form and we will email the account details.
    2. Print and place the QR code at entry points
      Make sure it’s visible, visitors must scan it before accessing your establishment.
    3. Customers scan the QR using their mobile phone to fill in the form
      It will take your visitors only 1 minute or less to complete the contactless form, speeding up the filtering process.
    4. Filter visitors before they access your establishment
      The system is designed to grant access only if the responses are favorable. Use this to filter entries, and notify those that might be of high-risk.

    Getting used to "the new normal." COVID self-declaration forms are required at spas, salons, skin clinics, restaurants, supermarkets, health facilities, stores, hotels, and malls, among others.

    Why go with traditional pen and paper forms when you can go digital?

    Frequently Asked Questions


    Do I have to pay to use the QR code forms? Are there hidden charges?

    The Contactless Digital COVID Screening Form is absolutely free to use. No hidden charges!

    How long can I use the Screening Form?
    You can use the free screening form as long as you like. If you want to close your account, simply contact us so we can delete your data.

    Can I modify the form questions?
    Yes, you can change the questions. Please contact us to create a custom solution.

    Can I put my logo on the form?
    Yes, you can insert your logo. Simply send us your company logo when you sign-up.

    How many QR contactless forms can I create?
    You can create one COVID-19 contactless form per account. To add multiple branches under one account, simply contact us.

    Is there a limit on the replies I can receive?
    If you expect to have thousands of monthly responses, please contact us.

    How many QR code contactless forms can I create within my free account?
    You’re free to print as many copies of the QR code form as you require, so there’s no limit on the copies. If you happen to need multiple different QR code forms, please contact us.

      Get your FREE digital screening form. Simply fill out the form below!

      Acceptable File Types: jpg, png, pdf