Visitors Risk Assessment Form

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Welcome to Avenue Primary School.

In order to ensure your safety and the safety of our pupils and staff on site we ask that you complete this form prior to entering the School.

Any personal data you provide will be omitted from the School data base within 14 days of your visit today.

Please note that on entry to the School you will be asked to wear a face mask. If you do not have your own, you will be supplied with one. If travelling through the building, it is expected that you follow the one-way system signage and keep a 2 metre distance from anyone else where possible.

Your cooperation in keeping all members of the School community as well as yourself safe is appreciated.

H Nazif
Headteacher

Email *

Name: *

Date of Visit to School: *

YYYY

Purpose of your visit: *

Name of School staff member you are visiting: *

Please tell us if you have any of the following symptoms:

A high temperature *

Yes

A new, continuous cough - this means coughing a lot, for more than an hour or three or more coughing episodes in 24 hours *

Yes

A loss or change to sense of smell or taste *

Yes

Please indicate if you have been in contact with a confirmed case of coronavirus within the past 14 days: *

Yes

Required

Please supply details you can be contacted on in the event that you have been in contact with a confirmed case of coronavirus within School: *

A copy of your responses will be emailed to the address you provided.

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