COVID-19 Policy Form

To prevent the spread of COVID-19 and reduce the potential risk of exposure to our workforce and clients, we are conducting a simple screening questionnaire.

Full Name

Please respond to the questions below

I am currently required to be in isolation because I have been diagnosed with coronavirus (COVID-19)
YesNo

I have 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)
YesNo

I have returned from overseas within the last 14 days
YesNo

I have symptoms of an influenza like illness including fever OR symptoms of acute respiratory infection (e.g. shortness of breath, cough, sore throat)
YesNo

I have read and understood IWF Staff's most up to day COVID-19 Policy and agree to follow all directions outlined in it
YesNo

Additionally, we ask you to 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

Wear a mask or face covering at all times whilst working

Adhere to the COVID Safe guidelines and practices of the company you are working for

Please Select A State (required)

Sign by typing name

I have read and filled out this form truthfully and to the best of my ability

About us
Employers
Staff
- Job Board
Contact
Blog

Your Name (required)

Your Email (required)

Phone Number (required)

State (required)

Resume (required)

Cover Letter

First Name (required)

Last Name (required)

State (required)

Area(required)

Skill set (required)

Your Availability for week beginning on (required)

MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Additional Comments