SELF-DECLARATION FORM

In view of COVID-19, H&H Optical Sdn Bhd (Pott Glasses) requires all customers to make this declaration before we could provide service (in optical shop). Be sure that the information you’ll give is accurate and complete. We regret to inform that we’re not able to provide service if you have any of the COVID-19 signs. Thank you for your time.

Self Declaration

DECLARATION:

BY CLICKING THE SUBMIT BUTTON , I CERTIFY AND AGREE THAT THE ABOVE INFORMATION PROVIDED IS, TO THE BEST OF MY KNOWLEDGE, COMPLETE AND TRUE.