WDHS Request for Onsite Visitor/s

1
Please be aware all visits to WDHS campuses or facilities will require approval to be onsite from the Chief Executive. All submissions are sent directly to the the Chief Executive to review.
2
Visitor type* This field is required.
Contractor
Staff Education
Staff Meeting (Face to Face)
Volunteer
3
Face-to-face training or meetings within the Education Centre:-

Meetings and/or Training sessions are limited to WDHS board, staff, VMO’s or students only (such as Deakin, CQU etc.); and

Meetings between staff, contractors and external stakeholders when possible should be conducted virtually or outside rather than indoors;

Education sessions when possible should be conducted virtually;

When a face-to-face meeting/education session is requested, clear rationale as to why virtual mode is not possible / appropriate must be provided;
4
Staff meeting venue* This field is required.Note maximum density limits
Auditorium (32 max)
Clinical Skills Room (10 max)
Computer Learning Hub (3 max)
HMO room (5 max)
Seminar rooms (12 max)
5
Description of Education
6
Who are the presenters / facilitators?
7
Number of attendees
8
Name of visitor/s* This field is required.
9
Date of proposed visit* This field is required.Is multiple dates please outline details in the Reason for visiting comment box
Date
Day
Month
Year
10
Duration of visit* This field is required.
0-4 hours
4-8 hours
> 8 hours
Other
Timeframe
Timeframe
0-4 hours
4-8 hours
> 8 hours
Other
11
Where are they coming from?* This field is required.
12
Reason for being onsite* This field is required.
Huge
Large
Normal
Small
Ok
Ok
13
What COVID risk mitigation measures will be in place?* This field is required.
Screening
Rapid Antigen Test
Surgical mask
N95 mask
Other
Visitor 1
Visitor 2
Visitor 3
Visitor 4
Visitor 1
Visitor 2
Visitor 3
Visitor 4
Screening
Rapid Antigen Test
Surgical mask
N95 mask
Other
Screening
Rapid Antigen Test
Surgical mask
N95 mask
Other
Screening
Rapid Antigen Test
Surgical mask
N95 mask
Other
Screening
Rapid Antigen Test
Surgical mask
N95 mask
Other
1 of 4
14
Department Head name* This field is required.
First Name
Last Name
15
Department Head contact number* This field is required.
16
Please enter your email* This field is required.
example@example.com
Should be Empty: