On the fulfillment of conditions according to the extraordinary measure of the Ministry of Health on the absence of COVID 19 symptoms or contact with those infected.

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name and surname: ……………………………………………………………………………….

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I, the undersigned

• I declare that I have not been in risky contact with a person who has been diagnosed with COVID 19 in the last 14 days in the last 14 days. At the same time, I declare that I do not suffer from the symptoms of COVID 19.

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• I declare and confirm (tick one of the following statements):

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• I declare that I underwent a PCR TEST, no longer than 72 hours ago at the sampling site with a negative result. I can confirm this by submitting a PCR negative test.

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• I declare that I am at least 14 days after the last dose of the approved vaccine against COVID 19. I can confirm this with a certificate from the Ministry of Health.

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• I declare that I have suffered from COVID 19 and that no more than 180 days have passed since the first positive test. I can prove this by a doctor's certificate.

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I am aware that by concealing the above facts, I can seriously endanger the health of conference visitors and the legal consequences of a false affidavit.

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Done at ………………………………… .. signed …………………………………………