Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Employee name:
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Did the employee record a reading of Zero?
- Yes
- No
- N/A
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Wait 10 minutes then re-test.
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Result:
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Second test - Did the employee record a reading of Zero?
- Yes
- No
- N/A
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A second "positive result" has been recorded, you will be asked to show a negative result before you can return back to work. You are to be assisted back to your house and will be stood down (without pay) as effective immediately. You may choose - a testing facility of our choice (Sonic Health) where you can choose to conduct a third test at your own cost.
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Result:
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Add signature
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Follow up 3rd party testing sought by employee?
