For your peace of mind, our employees will complete a staff wellbeing form every day they come in to work, and also take a temperature check. It all helps to keep us all safe. The form content is below, or you can see a downloadable PDF version here.

Daily Staff Wellbeing

COVID-19 is a new illness which can affect your lungs and airways.

It’s caused by a virus called coronavirus. The symptoms of coronavirus are:

  • A new, continuous cough.
  • A high temperature.
  • Loss or change to your sense of smell or taste – this means you’ve noticed you cannot smell or taste anything, or things smell or taste different to normal

The symptoms are similar to those of other illnesses that are much more common, such as the common cold and flu.

If you have any of the above symptoms you are not allowed to work, and you must go home and self-isolate. Please see gov.uk/coronavirus for advice on how to isolate and order a test.

We require you to confirm each day that you do not have any of the above symptoms (we have a temperature checker which we will use each day).

NAME ………………………………………………………………………

DATE…………………………………………………………….

I confirm that I do not have any of the above symptoms

Signed………………………………………………………….