COVIDSafe Contact Logbook

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

RH Photography & Design
COVIDSafe Plan & Policies
https://www.rhphotography.design/covid-19

A message from Rhiannon Hopley, Creative Director of RH Photography & Design, ABN: 47 843 465 299.

During these uncertain times with COVID-19 pandemic, we have been following the situation closely and are keeping up to date with government guidelines.

This form is for COVID-19 contact tracking.
It is a government requirement to help assist the tracking of COVID-19 outbreaks in NSW.

First Name *

Last Name *

Contact Number (Mobile or Work) *

Email address *

Have you had any of the following symptom(s) in the past few days? *

Fever (37.5ºC or higher)

Cough

Body Aches

Sore Throat

Difficulty breathing or flu like symptoms

NONE OF THE ABOVE

Required

Have you travelled interstate of overseas in the last 14 days ? *

Yes

Have you been in contact with a confirmed or suspected COVID-19 patient in the past 14 days? *

Yes

Would you like to be included in our VIP Mailing list for our quarterly updates and special offers? *

Yes

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of rhphotography.design. Report Abuse

Forms