COVID-19 Survey

The purpose of this survey is to minimize the spread and transmission of infectious disease (E.g. COVID-19) from all Legeneering work divisions which include both onshore and offshore facilities and proactively keeping our work teams safe at all times. To assist in this objective, could staff please ensure they answer the questions below truthfully, Thank you. 

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* 1. Date

Date

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* 2. Name

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* 3. Have you been in close contact with a person confirmed as having a case of COVID-19?

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* 4. Have you returned from an international or interstate location and entered Western Australia?

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* 5. Are you living or staying with a person who has traveled from anywhere outside Western Australia in the last 14 days?

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* 6. Are you currently experiencing any of the following symptoms?

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* 7. I declare that I have answered the above questions truthfully and understand that by providing a false statement I may be subject to disciplinary action, up to and including termination of employment

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