Platform Post - COVID19 Self-Declaration Form
Due to the ongoing and rapidly changing situation with Coronavirus (COVID-19), we are requiring all who are working in Platform Post's premises to fill out the self-declaration form below.

You must complete this form prior to every visit to Platform Post's premises. We will decide on access to the premises based on the answers provided.
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Email *
Name *
Date of Visit *
MM
/
DD
/
YYYY
Client or Platform Employee *
Company/Production *
Contact or production you are visiting *
The main symptoms of COVID-19 are:
• high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
• new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
• loss or change to your sense of smell or taste – this means you have noticed you cannot smell or taste anything, or things smell or taste different to normal
• Most people with coronavirus have at least one of these symptoms
Please answer the following questions:
I am displaying symptoms of COVID-19 as described above *
I should be self-isolating as I suspect I may have been exposed to or have been suffering from COVID-19 in the last 14 days and have not yet received a negative test result. *
I have been notified by the NHS test and trace service or the NHS COVID-19 App that I should self-isolate and have not yet received my test result. *
I am living in the same household as someone who is self-isolating *
I should be self-isolating after travelling from outside the Common TravelArea of the UK, Ireland, the Isle of Man, and the Channel Islands within thelast 14 days. *
I am considered “clinically vulnerable” as defined by the government’sCOVID-19 guidelines and should be “shielding”. *
If you have answered YES to any of the above questions, we regret that we cannot admit you to our premises today.
We have a legitimate interest in collecting this personal data to protect the health of our employees, contractors, and visitors. This information will be recorded and securely stored in accordance with our data protection and privacy policies [available on request]. This data will be deleted after [30] days.
A copy of your responses will be emailed to the address you provided.
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