Staff Sickness Form
Any staff or visitors (including contractors) who have vomited or had diarrhoea in the 48 hours before entering the food premises. You must not come to work if ou have vomited or had diarrhoea in the 48 hours before entering our food premises. You must tell their supervisor.
Completed by *
Name of Staff Member who is sick *
Symptoms (state if vomited at work or diarrhoea in last 48 hours) *
Date of symptom onset *
MM
/
DD
/
YYYY
Time of symptom onset *
Time
:
Action Taken - check all that apply *
Required
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