TURKISH REPUBLIC OF NORTHERN CYPRUS
MINISTRY OF HEALTH
MONITORING INFORMATION AND CONSENT FORM AT QUARANTINE LOCATION SPECIFIED WITH RESPECT TO COVID-19
It has been decided by “the Ministry of Health” within the scope of COVID-19 measures that quarantine follow-up be carried out by Quarantine Follow-up Center and teams at home and/or hotel and/or the quarantine location you have stated due to your arrival at the island from abroad and/or the fact that you are contact with a patient and you are required to under isolation/quarantine during the period determined and/or to be determined by “the Ministry of Health” and/or the Supreme Board for Communicable Diseases. Within this scope, the rules you are required to do and comply with are as follows:
1) During the quarantine period determined, you are required to stay at home and/or hotel and/or the quarantine location you have stated and not to leave stated locations in any way whatsoever. You are required not to take off and/or not to damage and/or not to destroy and break intentionally the wristband you are to wear during the quarantine period and/or not to cut the cordon of the wristband in any way whatsoever.
2) You are required not to dislocate the wristband you are to wear during the quarantine period from its connection point and/or not to end the operation of the application you have downloaded to smartphone and/or not to prevent the application from running on the background and from sending location and/or it is required that the Bluetooth connection of your telephone be open continuously and/or the charge of your telephone not be at low battery level and you are required to carry along your phone with Internet connection being on position on a continual basis.
3) For the period you are found at home and/or hotel and/or the quarantine location you have stated, your health condition may be followed up by your doctor and/or the persons (nurse, doctor, etc.) designated by the Ministry of Health via telephone. In case you feel sick or your general condition worsens, call 1102 and inform your condition and seek medical care.
4) In case where you stay at home, you should remain alone or stay in a well ventilated and different room than others’ room if possible in order to prevent the risk of infection. Especially, the individuals being at the age of 65 and above and/or having risk factor who may cause COVID-19 to progress slowly living at the home should not be found at home if possible or you should minimize the contact risk.
5) You should not welcome guest to the place where you are found during quarantine.
6) Your location will be followed up the persons designated by “the Ministry of Health” and/or police by way of your wristband and smartphone on a continual basis for the period during which you are found at home and/or hotel and/or the quarantine location you have stated. During the random controls made and/or in case persons go into violation status, visits shall be paid by the persons as shall designated by “the Ministry of Health” and/or persons in Quarantine Follow-up Field operation and/or police to the address where people are staying for control purposes. Besides, you may be called by Quarantine Follow-up Center via telephone with and/or without video call for control purposes. In case it is determined that you have committed violation, the necessary actions will be initiated by
7) In case where you damage and/or break the wristband under the ownership of “KKTCELL”,
In case I act contrary to the instructions, I have been informed that a criminal complaint will be filed against me within the scope of the provisions ““(6) (A) In case of breach of mask and/or social distancing rules by acting against the rules in paragraph (2) of Article 36 of the Communicable Diseases Act, an administrative fine equal to 1/10 (one tenth) of monthly gross minimum wage is applied. (B) Those who break the rules relevant to declarations and/or commitments in the content of the letter of undertaking having signed by the Ministry, who break the isolation rules or quarantine rules by acting against the rules in paragraph (2) of Article 36 of the Communicable Diseases Act commit a crime and in case of conviction, they may get fined equal up to 5 (five) times the monthly gross minimum wage or may be sentenced to prison for up to 1 (one) year or sentenced to both penalties. (Ç) Those who violate the provisions of the paragraph (4) of Article 36 of this Law, who do not comply with the house quarantine rules, are given an administrative fee which is 5 (five) times the monthly gross amount of free. In addition, person and / or persons who violate the home quarantine rules is / are placed in the central quarantine determined by the Ministry and they will pay the quarantine fee foreseen by the Council of Ministers Decision.” in Article 43 subtitled “Administrative Sanctions and Crime and Punishment” of Communicable Diseases Act number 45/2018 and/or other provisions in the law.
After being informed of the above, I hereby undertake that I have read the “MONITORING INFORMATION AND CONSENT FORM AT QUARANTINE LOCATION SPECIFIED” and approved the same electronically and/or in writing and I will comply with the instructions in relation to monitoring at home/hotel and/or the quarantine location I have stated. Otherwise, I hereby acknowledge and declare explicitly that my wristband quarantine will be ended and isolation practice will be applied with my own opportunities at the place (hospital, hotel, dormitory, etc.) to be determined by authorities.