CLI-Contact Tracing Survey

Let us help keep our community safe!
Kindly fill-up this survey form and present the confirmation upon entry. Thank you!

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Customer Supplier Others:

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Name *

First

Last

Company *

Address *

Phone Number *

Email *

Branch Visited *

I hereby authorize Chocolate Lover Inc. to collect and process the data indicated herein for the purpose of contact tracing effecting control of the COVID-19 transmission. I understand that my personal information is protected by RA 10173 or the Data Privacy Act of 2012 and that this form will be destroyed after 30 days from the date of accomplishment, following the National Archives of the Philippine protocol *

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CHOCOLATE LOVER INC. - CUBAO
45 P. Tuazon Blvd. corner C. Benitez St.
Cubao, Quezon City

Monday to Saturday
9:00 AM to 6:00 PM
Sunday CLOSED

(02) 8724-5752 / (02) 8724-4964

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Privacy Policy
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Return and Exchange Policy

Let us help keep our community safe! Kindly fill-up this survey form and present the confirmation upon entry. Thank you!

Let us help keep our community safe!
Kindly fill-up this survey form and present the confirmation upon entry. Thank you!