Staff/Therapist/Contractor Name

Time in

Is your temperature above 37c on temperature gun? (gun is lower than normal thermometer)

Does have any symptoms of COVID 19? (high temperature, new persistent cough, loss of smell or taste)

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.