Contact Tracing Log
As we move to COVID Alert Level 2, in-person services become possible again!
To do this safely, we are asking clients to complete this form before all in-person sessions to make sure that we have double check each day that no one is sick and to make sure we can easily share the best email/phone number with contract tracers if that becomes necessary.
This information will be kept confidential for up to 4 weeks and will only be used if required by public health rules.
You are also free to use a method that is easier for you if this form is challenging
022 499 6737
In the past 14 days, has anyone in your family been sick, in isolation, overseas, tested positive for COVID, or suspected to be in close contact with someone who has?
Do you agree to keeping our hands and surfaces clean during the session? We will bring sanitiser.
Do you promise to quickly let us know if anyone in your family is exposed to COVID-19?
Who is the best person to contact in your family if one of our clinicians is exposed to COVID?
If it becomes necessary for contact tracers to contact you, what is the best way to reach you:
Send me a copy of my responses.
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