Covid-19 Protocol Sign-in For New Zealand Construction Sites
SITE ADDRESS/LOCATION
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Minutes
Name
First Name
Last Name
Company name
People you travelled with
Phone number
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Area Code
Phone Number
Are you feeling unwell?
Yes
No
Have you had any Covid-19 symptoms: Fever over 38 degrees, dry cough, shortness of breath?
Yes
No
Have you been in contact with someone with COVID-19 symptoms
Yes
No
Have you arrived in New Zealand in the past 14 Days?
Yes
No
Planned destination after leaving this site
This could be the next job site your visiting or a shop etc, this is for covid contact tracing and will only be shared with Ministry of Health or other govt officials in the event that contact tracing is required
Please confirm that you have received site induction from Apex Construction (Nelson) Ltd
YES
NO
Signature
Submit
Should be Empty: