On-site visit

Visit to your Premises - Health Requirements
Contact Details*
Company Name First Name Last Name
Email*
Date of scheduled visit*
DD slash MM slash YYYY
On Site support for:*
- IT & Net2
- ERP / Tencia / Arrow / MYOB
- Other
Name of Communicat Consultant who will be visiting you:
(or leave blank if not known)
1. Does your business follow the following practices?*
- o Physical distancing
- o Hand hygiene/handwashing
- o Act quickly in the event of a known health risk, to minimise the spread of infection
- o Avoid interactions in enclosed spaces
- Yes
- No
2. Is there any person within your premises, or that our employee may encounter, who has returned from overseas within the past 14 days?*
- Yes
- No
3. Is there any person within your premises, or that our employee may encounter, who you are aware of as being at risk of exposure to Corona Virus, COVID-19 or any other known infection during the past 14 days?*
- Yes
- No
4. Can you confirm that the persons we will meet at your site have been vaccinated?*
- Yes
- No
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Or upload a copy of your plan document here
Max. file size: 2 MB.
5. You will instruct you staff to observe social distancing towards our consultants. You understand and will respect that our consultants will wear a mask when visiting your site. Please note that in some situations we may need to perform physical work, in which case our consultants may need to remove their mask. In these circumstances our consultants must be provided with a private workspace that is socially distanced from other persons.*
- Yes
- No
6. Are you a senior manager within your company and therefore authorised to confirm that the factors stated in this form are accurate?*
- Yes
- No
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3. Have your staff have been instructed to observe all current social distance rules and guidelines?
visit this link for further information
- Yes
- No
Do you have any special instructions or comments?

Visit to your Premises - Health Requirements