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Burbank COVID-19 Checklist
Burbank COVID-19 Checklist
Frank Perconte

Burbank COVID-19 Checklist

Customer/Visitor/Trade Question set and response protocol

Use this Digital Checklist
Download as PDF
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Free Burbank COVID-19 Checklist Checklist

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Information & Questions

At Burbank, we are doing everything possible to keep our customers, staff, contractors and the wider community safe.
In line with the Government's bans we are taking several measures including this checklist for you to complete to ensure we operate in a safe environment for all.

Have you or someone you've been in close contact with, retuned from overseas in the last 14 days?

Have you familiarised yourself with the Federal Government Guidelines to self-isolate (implemented 16/03/20)

Close contact is defines as:
- Spending more than 15min face to face with a person, in the 24hrs before they showed any symptoms or once they showed symptoms.
- Sharing a closed space for more than two hours with a person, in the 24hrs they showed symptoms or once they showed symptoms.

Have you been feeling unwell or in close contact around someone that has been feeling unwell?

Have you or the person who has been feeling unwell, tested positive to COVIS-19

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Name & Signature
Name & Signature
Name & Signature
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Burbank Response Guide

Have you or someone you've been in close contact with, returned from overseas in the last 14 days
if Answer is YES

Do not attend the customers home or arrange face to face contact until they have completed 14 days self -isolation or self quarantine.
Do not continue with face to face meeting.

Note the start date on the client file
Make contact with them at the end of the period to confirm they are cleared.

Have you familiarised yourself with the Federal Government Guidelines to self-isolate (implemented 16/03/20)
if the Answered is No

Advise them to head online and familiarise themselves with the document :
www.health.gov.au/resources/publications/cornavirus-covid-19-islolation-guidance

Have you been feeling unwell or in close contact around someone that has been feeling unwell?
If the Answered is YES

Do not attend the customers home or arrange face to face contact until they have completed 14 days self -isolation or self quarantine.
Do not continue with face to face meeting.

Note the start date on the client file
Make contact with them at the end of the period to confirm they are cleared.

Have you or the person who has been feeling unwell, tested positive to COVID-19?
If Answered YES

Do not attend the customers home or arrange face to face contact book the appointment 14 days time.
Do not continue with face to face meeting.

Reconfirm the checklist with the client at that time.

NOTE : if you need to undertake any of the above actions, please ensure you advise you Burbank line manager and ensure the customer file is updated in Click or you equivalent system and filed on our server. For further protocol details, talk to your line manager.

Burbank COVID-19 Checklist
Frank Perconte

Burbank COVID-19 Checklist

Customer/Visitor/Trade Question set and response protocol

Use this Digital Checklist
Download as PDF
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.

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