Example - COVID Little Survey

This form is for demo purpose only. Form submission will try to send result to imaginary WhatsApp number +6212 3456 7899

Are you a COVID-19 Aware person? Check your awareness!

In the last few days, have you worn a mask when you were in a crowded place? *

In the last few days, have you implemented physical distancing when you were in the crowd? *

In the last few days, have you immediately changed your clothes before entering the house and having contact with family members? *

I agreed my form submission will be used for research and education purpose