Test & Trace: Leytonstone Masjid
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Email *
About this form
Leytonstone Islamic Association, as a place of worship, is required by Government guidelines to maintain a record of all attendees who have attended the Masjid as part of the NHS test and trace system.

To complete this form is optional, and requires your consent.

By completing this form you agree for your details (entered on this form) to be transferred to the NHS Test and Trace System in the event that a visitor/worshipper/staff member/volunteer tests positive for Coronavirus. You will then be contacted by the NHS Test and Trace team, who will inform you whether or not you need to self isolate in order to help stop the spread of the virus.

For more information on the NHS Test and Trace System and for information on how it works, visit: https://www.gov.uk/guidance/nhs-test-and-trace-how-it-works

We will also send you a confirmation email, confirming that we have received your details, and that you have been added to our list. Should you wish at a later date to have your details removed from Leytonstone Masjid's NHS Test and Trace list, please email your request to contact@leytonstonemasjid.org.uk

The data collection and storage part of this service is in part provided by Google Cloud and is subject to the Google Terms of Service (https://policies.google.com/terms) and Privacy Policy (https://policies.google.com/privacy), as well as the End Users Using Scripts or Add-ons. (https://developers.google.com/apps-script/terms#end_users_using_scripts_or_add-ons).
Full Name *
Phone Number *
Consent *
Visiting as a Group/Family? *
If you are visiting Leytonstone Masjid as a family or a group together, you can add the name and contact number of members of your group, provided you have obtained consent from them to do so.
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