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Visitor Self-Declaration Questionnaire
Lime Academy Hornbeam
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Private Data Protection notice:

We are collecting and processing this personal data on the basis of Art. 6 (1)(f) and Art.9 (2)(i) Regulation (EU) 2016/679 (“GDPR”) being necessary for the purposes of the legitimate interests pursued by Lime Academy Hornbeam and necessary for protecting against serious cross-border threats to health.
 
We do this as preventive measures for our community to mitigate the risk of a novel Coronavirus disease (COVID-19) outbreak in our Academy. Also, we are collecting personal data to be able to support local authorities in case of an outbreak in the United Kingdom. In such a case, this data will help the authorities to trace a human-to-human transmission of the Virus.
 
This data sheet will be stored in School Office(s) and is not shared with any third party, unless there will be an official request by the local authorities for reasons of public interest in the area of public health.  
 
The data collected will be deleted 21 days after collection, unless a longer period is required by the public authorities.

Name: *
Who / where are you visiting?
Which campus are you visiting? *
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Time
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Have you returned from abroad within the last 14 days? (Government advice is forall travellers arriving in the UK should self-isolate for 14 days) *
Have you had close contact with, or cared for, someone diagnosed withCOVID-19 within the last 14 days? *
Have you experienced any cold or flu-like symptoms in the last 14 days (to include high temperature, fever, cough, sore throat, respiratory illness, loss of smell/taste, difficulty breathing? *
 Note: If you plan to be onsite for consecutive days, please immediately advise the school office if any of your responses change.
Contact number for tracing
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