Covid-19 Declaration Form

hereby certify that I have not within the last 14 days;

• Tested positive or am presumptively positive with the Coronavirus or been identified as a potential carrier.

• Experienced any symptoms commonly associated with the Coronavirus.

• Been in any location designated as a risk by the Government.

• Been in direct contact with or in the immediate vicinity of any person been identified as a carrier or potential carrier of the Coronavirus.

I will consent to having my temperature taken by a member of Made to Engage’s staff prior to entrance to the project site and facilities. I acknowledge and accept that this declaration will be considered as my consent to record and store this declaration for the purpose of ensuring the safety of all persons that may encounter me during my visit.

It will be retained in soft copy format prior to visit and will only be accessed by authorised employees. We will only retain this information for as long as it remains relevant and for a maximum of six months. Made to Engage’s  privacy statement is available on request.