Covid 19 Return to Work Questionnaire

In order to implement COVID-19 Prevention and Control Measures to Minimise risk to Staff and in accordance with the Return to Work Safely Protocol issued on May 9 2020, all staff are required to complete the following questionnaire and return it to work at least three days before their anticipated return date.

By completing this form you are confirming to the best of your knowledge that you have no symptoms of COVID19 and that you are not self-isolating or awaiting the results of a COVID19 test

I confirm to the best of my knowledge that I have no symptoms of COVID19 and I confirm that I am not self-isolating or awaiting the results of a COVID19 test.
*If any staff answer Yes to any of the questions, they are strongly advised to follow the medical advice they receive or seek medical advice before returning to work.

*If any staff answer Yes to any of the questions, they are strongly advised to follow the medical advice they receive or seek medical advice before returning to work.