COVID-19 Visitors Screening Questionnaire

Please complete our online Covid 19 risk assessment prior to your arranged visit.

This form should be completed on the morning of the day of your visit, not before.

You are advised to:

  • Please wear a face mask or covering
  • Use the provided hand sanitiser on entry to the building
  • Keep a safe distance from staff at all times

If you are displaying any COVID symptoms on arrival, we will kindly ask you to leave the site and rearrange your visit at a later time.

It is your responsibility to cancel the visit should your medical circumstances regarding Covid 19 change.

Thank you for helping us to keep our office safe.

Critical illness cover - PFG Insurance

COVID-19 Visitors Screening Questionnaire

Please complete our online Covid 19 risk assessment prior to your arranged visit.

This form should be completed on the morning of the day of your visit, not before.

You are advised to:

  • Please wear a face mask or covering
  • Use the provided hand sanitiser on entry to the building
  • Keep a safe distance from staff at all times

If you are displaying any COVID symptoms on arrival, we will kindly ask you to leave the site and rearrange your visit at a later time.

It is your responsibility to cancel the visit should your medical circumstances regarding Covid 19 change.

Thank you for helping us to keep our office safe.

    COVID-19 Visitors Screening Questionnaire
    1. Name

    2. Phone Number

    3. Email

    4. Who are you coming to visit?

    5. I have not had COVID in the last 5 days, nor am I awaiting a PCR test result or knowingly been in contact within anyone with COVID in the last 5 days.

    6. Would you prefer your advisor to we a face mask during your appointment?


    * Required

    Thank you for your understanding and co-operation during these unprecedented times.

     

    Limiting the spread of infection is everyone’s responsibility.

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