How to write a statement without nucleic acid testing?

Self-health status and commitment to the authenticity of relevant information

Name: Gender:; Contact telephone number:

Work unit or school:

I have understood the relevant requirements of epidemic prevention and control in winter vacation, and I have conducted self-health monitoring for 7 consecutive days before the start of school. Now I promise as follows:

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Yes/no

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1.2 1 day Have you ever lived in Hongkong, Taiwan Province or abroad?

2./kloc-Have you been abroad or to the local provinces (autonomous regions and municipalities) with epidemic situation in 0/4 days, and have you been to Baise City and 8 counties (municipalities and districts) on the border of Guangxi (Napo County, Jingxi City, daxin county, Longzhou County, Pingxiang City, Ningming County, dongxing city, Fangcheng District)?

3. Have you done a good job of self-protection on the way back from home and consciously cooperated with temperature measurement.

4. Whether to report to the school and the community (village) 24 hours in advance before returning from other provinces and cities, whether to do nucleic acid testing within 48 hours before returning to China, and whether to report to the school and the community (village) within 12 hours after arriving in your country.

5. Whether the days of centralized isolation observation, home isolation observation, home health monitoring and the times of nucleic acid detection have been completed according to regulations after returning from other provinces and cities.

6. Did you do nucleic acid testing within 48 hours before returning from Baise City and 8 counties (cities and districts) bordering Guangxi (Napo County, Jingxi City, daxin county, Longzhou County, Pingxiang City, Ningming County, dongxing city City and Fangcheng District), and did you do nucleic acid testing after arriving in your country?

7. Have you had any contact with confirmed cases, suspected cases, known asymptomatic infected persons and home isolation observers in COVID-19 within 14 days?

8. Did you have any symptoms such as fever, dry cough, fatigue, sore throat, hypoesthesia and diarrhea within 0/4 days of/kloc, and infectious diseases were not ruled out.

I guarantee that the above information is true, accurate and complete. I (guardian) who makes false promises, conceals medical history and contact history, intentionally suppresses symptoms, conceals or omits health status, or evades epidemic prevention measures will bear corresponding legal responsibilities. Commitment (signature): Commitment guardian (signature): Date of signing the commitment letter: February 2022.