Covid-19 Declaration Record Sheet

Covid-19 Daily Health Check Declaration and Attendance Record

EMP.RTW.05

This Covid-19 Daily Health Check Declaration and Attendance Record can be used to collate and record each day’s confirmed Covid-19 Daily Health Declaration Emails. All employees, contractors and visitors must complete and return the Declaration by email each day before they attend the workplace. This confirms that they have not knowingly been in contact with an infected person, have been maintaining social distancing and do not have symptoms themselves. This is part of creating the safest possible working environment for employees, contractors and visitors coming back to the workplace.

It is important that this whole process is carefully monitored and that one or more individuals are responsible for this recording process being carried out properly. A designated person or persons should be responsible for filling in the form preferably in an online version, to avoid creating an area of potential transfer.

This document is in open format. Either enter the requisite details in the highlighted fields or adjust the wording to suit your purposes.

Once you have subscribed to the appropriate document folder click on the “Download Document” button below. You will be asked what you want to do with the file. It is recommended that you save the document to a location of your choice prior to viewing.

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