Free Covid-19 Contact Tracing Form
You can save lives now. Get up and running immediately.
If you need help contact us here.
Please note, this form is a legal requirement in many countries, with severe penalties for non-compliance. As an example, please refer to clauses 10B (b) & (c) for Singapore on the following link from Singapore Statutes Online.
https://sso.agc.gov.sg/SL-Supp/S262-2020/Published/20200410?DocDate=20200410
We are providing these Digital Covid-19 Contact Tracing Forms for companies to use for FREE as they need to do so. Please refer to the FAQs at the bottom of this page to answer all your questions about data ownership, PDPA, GDPR, data access, data deletion, etcetera.
No Need To Download Any App.
Just Scan QR Code On Camera Or Type In Url Into Browser.
STOP THE SPREAD. WHILE OPENING UP THE ECONOMY SAFELY.
Organisations are getting crippled. People are working from home, reducing retail, mall, entertainment and F&B patronage. Transportation has been hit. B2C revenue has dropped and staff are being retrenched. B2B meetings are being cancelled, as are contracts. Air travel is compromised, the meetings, exhibition, conventions and events (MICE) industry is in turmoil and tourism has been curtailed. Manufacturers have sent workers home, and the global supply chain is severely impacted. There is only that much fresh credit governments can inject into the economy to salvage the situation.
No one knows how long the Covid-19 outbreak will last. But your organisation can do something to help itself and others to stop the spread and open up the economy safely.
WE ALL HAVE TO PLAY OUR PART.
Take social responsibility. Be a good corporate citizen. Get your FREE ONLINE COVID-19 CONTACT TRACING FORM up and running now.
YOUR COVID-19 CONTACT TRACING FORM WILL INSTANTLY DIGITISE AND TIMESTAMP YOUR:
1) Customers' contact data at your various locations and touchpoints. This includes their body temperature, travel, health and proximity declarations.
2) Staff attendance along with their body temperature data, as many times as required daily.
3) Visitor registration information, so you know who was on your premises and when.
USE YOUR DIGITISED COVID-19 CONTACT TRACING DATA TO:
1) Build consumer confidence and have people feel safe on your premises by communicating you are a socially responsible organisation.
2) Help your health authorities with the relevant digitised Covid-19 Contact Tracing Data for their Covid-19 contact identification, listing and follow up purposes.
3) Arrest the transmission of the Covid-19 Virus and save lives.
Stop Spreading The Virus By Forcing People To Fill Up Paper & Pen Based Contact Forms.
Go Digital.
Get People To Scan QR Code / Type In URL On Their Your Own Device, Fill Up Details And Walk In.
Quick Step-By-Step Set Up Guide
STEP 1
Create a new account at https://default.cusjo.com/signup then follow the instructions till you get to the "Select Survey Template" page.
STEP 2
On the "Select Survey Template" page type in, "Covid" into the search box. Then click on the "Covid-19 Contact Tracing Form".
STEP 3
You will now be at "Template Preview". Click on "Build" build button to its right. This is where you can edit the questions, but only if you need to. Then click, the "Save" button under the "Build" button. You will see "Theme", "Preview", "Publish" and "Analyse" turn up to the right of it.
STEP 4
Click on "Publish". Type in "Covid19" in the box to the left of "Save" then click "Save". next click "Publish Survey". A pop up box will ask for a confirmation. Click "Ok" on the pop up box. Your QR Code and URL will appear below the "Publish Survey" button.
STEP 5
Right click on the QR Code and "save image as". Your QR Code image should now be in your Download folders. Go to any document (MS Word, Google Docs, Apple Pages or MS Powerpoint, Google Slides, Apple Keynote), copy the words below, add in your QR Code from your download folder, and add in your URL from the Publish Page. Print out your poster and display it prominently wherever you need contact data to be collected.
Here is the text to copy, paste and print.
Your Well-Being Is Our #1 Priority.
Please complete our Contact Tracing form before entering our premises.
{Add in QR Code and URL here}
It will take less than 30 seconds and will make you feel a lot more comfortable too. Thank you!
STEP 6
Get your patients to either scan the QR code on their smartphones (apple / android) or type in the URL in their browsers, so they can "Submit" the form on their own device without having to even touch any common device.
STEP 7
Once they click "Submit" you will get instantaneously digitised time stamped data, to access in case of an emergency. No more cumbersome paper-based process and data entry required. Go to "Analyse" on your domain (e.g. YOURCOMPANY.cusjo.com) then click on "Response". You can also export your data by clicking on "Export" and then "Excel".
Example of Covid-19 Contact Tracing Form
You can customise this form to suit your Business-to-Business, Business-to-Consumer, Government-to-Citizens, religious, social and private group purposes.
Scan QR Code or click on a link to see demo.
https://demo.cusjo.com/covid19
How It Works From Your Customers', Staffs' & Visitors' Point Of View
Easy, Fast & Efficient.
1. People arrive and see your poster.
2. They use their own smart phone to scan QR code / or type in URL into a browser.
3. They fill up the form, click submit and walks in.
Frequently Asked Questions
1) Is the Covid-19 Contact Tracing Form free and for how long is it free?
It is completely free and for you to use as long as you need to.
2) Can I use my Covid-19 Contact Tracing Form across any social media and communication platform?
Yes. You can also put it on posters, embed it into your website, mobile apps, social media channels, into videos, intranet or anywhere necessary. All you need to do is copy and paste your URL and prominently put up your QR Code with your call to action message.
3) Can the Covid-19 Contact Tracing Form be used anywhere in the world?
Yes. Including China. We are not barred by any country's firewalls as far as we are aware.
4) Is my data mine and secure?
Yes, the data is solely yours, accessible by your appointed administrator who has a username and password. You can download the data and delete it from your https secured company specific domain at any time. It is recommended you keep the data there for 90 days and delete any data that is more than 90 days long. You can do this on your Response page under the Analyse tab.
5) Can I upload my own Personal Data Protection Act (PDPA) and General Data Protection Regulation (GDPR) policies?
Everything on the form is editable. You can copy and paste your own internal organisation policies in the disclaimer either just above or below the Submit button. You can also add and delete questions as appropriate to you and theme the form to your brand.
6) How do I ensure everyone who engages with my organisation fills in their details?
Once you have built your form, published your URL and QR Code, you can put them up at all entry points to either get people to fill it in on the spot or in advance, as appropriate. Once they complete their form, on Analyse under Response, you will be able to see their response upon refreshing the page. Once you see their details you can read them. If they meet your criteria, you can safely let them into your premise or deny them entry.
7) How do I use my Covid-19 Contact Tracing Form to help local and international health authorities?
In the event someone who visited your location was asymptomatic at the time of their visit and was subsequently known to have tested positive for Covid-19, you can lost at your excel sheet, identify all the individuals who were in contact with this person, and hand over only the relevant data to your local and international health authorities to contact, test, quarantine and isolate the right individuals to prevent further transmission of Covid-19.
8) What sort of industries should be using this form?
The form should be used by all essential and non-essential services alike. You can modify the form for any purpose whether you are a B2C, B2B, G2C or not-for-profit organisation. It is equally useful for religious groups, societies, social and private gatherings. Basically anywhere where people meet and want to be safe rather than sorry.
9) Can this be translated into other languages other that English?
We are in 106 languages. The default language is English. If you need it translated into any other language please contact us. We will need to enable our realtime AI translation and assist you. Please note outside of this and the next question, the form and platform is designed to be self-served.
10) What if I am a large global organisation with touchpoints all around the world?
This version can still serve your needs. Create a drop down and upload all your international locations on it. Then your visitors can pick the location they are at as they fill in the form. If you however need different people at different locations to administer the platform you will need to contact us. We will have to assist you create multiple touchpoints in line with your global hierarchy and associate a unique log in for each touchpoint for your staff. This will be to ensure the relevant data is only shared with the relevant people in each country and touchpoint.
11) What size of groups can I use the Covid-19 Contact Tracing Form for?
You can use the form for groups as small as 5 people in a very private gathering or 50,000 people at a conference or event.
12) Who are you doing this on behalf of?
This is a ground up effort to assist and we are doing it for free. We decided to do this when:
a) we were alerted to the fact that the government advisory for organisations was to, if practical, maintain a registration list, carry out temperature screening, look out for respiratory symptoms such as cough or runny nose, deny entry to unwell individuals, track travel history and make a health declaration, and
b) when we realised most organisations did not have a fast, effective and digitised method to assist in contact tracing efficiently, and to build one would be too costly and take too long.
13) What are some things that are critical for this to work?
Companies need to be honourable and not use the data for any other purpose other than contact tracing, or trust will be broken and never repaired. People too need to give accurate data or they will put themselves and their loved ones at risk.