JIM’S COVID-19 PARTY HEALTH DECLARATION

the main symptoms of covid-19 are:

high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)

new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)

loss or change to your sense of smell or taste – this means you have noticed you cannot smell or taste anything, or things smell or taste different to normal

Most people with coronavirus have at least one of these symptoms, and we have a legitimate interest in collecting this personal data to protect the health of our friends and visitors. This information will be recorded and securely stored in accordance with our data protection and privacy policies [available on request/available online].

PLEASE ANSWER THE FOLLOWING QUESTIONS (If you answer YES to any of the questions below, we regret that we cannot admit you to the party today, you’ll have to stand in the garden on your own):

Party Date

you must fill in this form each day before arriving on set

YYYY

Name

First Name

Last Name

a) I am displaying symptoms of COVID-19 as described above.

b) I should be self-isolating as I suspect I may have been exposed to, or have been suffering from COVID-19 in the last 14 days and have not yet received a negative test result.

c) I have been notified by the NHS test and trace service or the NHS COVID-19 App that I should self-isolate and have not yet received my test result.

d) I am living in the same household as someone who is self-isolating.

e) I should be self-isolating after travelling from outside the Common Travel Area of the UK, Ireland, the Isle of Man, and the Channel Islands within the last 14 days.

f) I am considered “clinically vulnerable” as defined by the government’s COVID-19 guidelines and should be “shielding”.

g) Have you ever suffered from SHAG (syphilis, herpes, AISDS or gonorrhea) before. Ems is providing pancakes and place for anyone who has -it's the only thing she can fit under the door.

h) Have you attended any other parties with other 50 year olds within the last 14 days.

please notify us if you develop symptoms within 14 days after this shoot

Feedback

Please let us know what we can bring and what time! xx