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Covid-19 Arrival Form
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Covid-19 Arrival Form
Covid-19 Arrival Form
Jennifer Vinson
2021-09-05T00:11:50+10:00
In order to protect all visitors and staff entering the Forest Lake Campus, all must sign in on the following register and acknowledge whether or not they have any of the symptoms associated with COVID-19. If you have any of the symptoms below, awaiting results from a COVID-19 test, have been instructed to isolate or have entered the country within the last 14 days you will not be permitted to enter the building. **These symptoms include: Temperature greater than 37.5o, Cough, Sore throat, Fatigue, Respiratory illness or Difficulty breathing**
Name
*
First
Last
Date
*
Date Format: MM slash DD slash YYYY
Arrival Time:
*
:
HH
MM
AM
PM
Phone
*
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Email
*
Are you experiencing any of these symptoms? Fever greater than 37.5 Degrees
*
Yes
No
Cough, Sore throat, Fatigue, Respiratory illness or Difficulty breathing
*
Yes
No
Have you been in contact with a person confirmed sick with COVID-19?
*
Yes
No
Have you attended any of the Locations (at those times) on the contact tracing list from the Qld Government?
*
Yes
No
Comments
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