CoVid-19 Sign In Form
Additionally, we ask that you support us to reduce the risk of passing on infections by:
• Avoiding direct contact with residents and exercising personal social distancing by
staying at least 1.5m from others.
• Washing your hands often with soap and water or alcohol-based hand sanitiser
• Wiping down surfaces regularly with an effective sanitiser or disinfectant
• Covering your coughs and sneezes with a tissue or the crook of your elbow.
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Email *
Full Name *
Are you currently required to be in isolation because you have been diagnosed with coronavirus (COVID-19)? *
Have you been directed to a period of 14-day quarantine by the Department of Health and Human Services as a result of being a close contact of someone with coronavirus (COVID-19)? *
Do you have symptoms of an influenza like illness including fever OR symptoms of acute respiratory infection (e.g. shortness of breath, cough, sore throat), *
Contact Number *
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