Covid-19 Declaration Record Sheet

Covid-19 Daily Health Check Declaration and Attendance RecordNew

HS.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 staff, contractors and visitors must complete the Declaration on a daily basis, to confirm 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 attending your workplace.

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

It is important not to create areas of potential transfer by using signing in sheets or having people filling in forms once or twice a day, for this reason the Covid-19 Daily Health Declaration does not have an attached signing sheet. Instead, the designated person must email a copy of the Declaration to each employee, contractor and visitor on each day/evening before they are intending to come into work on the next day. Then each individual has to email their daily confirmation to the workplace before they attend work and this Record can be used to record the process.

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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