CTS Staff COVID-19 Screening Questionnaire

In response to the recent Coronavirus (COVID -19) outbreak and the raised pandemic alert status by the World Health Organisation (WHO) and the UK Government, Chase Training Solutions is taking precautions to lessen the spread of the virus and protect all those that we engage with. All employees, independent contractors and freelance staff must have a screening form completed and submitted prior to taking part in the activity for which they have been engaged.

CTS STAFF COVID-19 SCREENING FORM

Please review the following self screening criteria:

First Name *

Last Name *

Email *

Date of Birth *

Date of Activity (from/to) *

I confirm that I have received a negative result from a Lateral Flow Test within the past 48 hours. Please note that this is a requirement as part of Chase Training Solutions' COVID-19 Risk Assessment *
Yes

By submitting this document you agree to a non-contact temperature check upon arrival at the activity venue and, if deemed necessary, at any point during this activity *
Yes

Signature *

Date/Time *

CTS STAFF COVID-19 SCREENING FORM

Please review the following self screening criteria:

If answered YES to any of the above questions, notify Ben Cleverley or Dave Mayo immediately.