Heath Questionnaire | 3k1cscouts

Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

Section Attending

This person's body temperature is lower than 98.6°F/ 37.5°C

This person is not experiencing the symptoms: fever, cough, sore throat, shortness of breath, loss of sense of smell?

This person hasn’t been in close contact with a Covid-19 patient in the last 14 days

Parent/Guardian email

I confirm, to the best of my knowledge that I have no symptoms of COVID-19, am not self-isolating or awaiting results of a COVID-19 test. Please note: The organisation is collecting this sensitive personal data for the purposes of maintaining safety within the workplace in light of the Covid-19 pandemic. The legal basis for collecting this data is based on vital public health interests and maintaining occupational health and will be held securely in line with our retention policy.

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3K1C Newcastle

Scouts

Covid-19 Health Declaration

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