This is a demonstration of the health declaration for your production.
As your employer begins planning for staff returning to work, they have engaged in a risk assessment process, looking at possible control measures for specific tasks, travel and adopting current government guidance and requirements specific to COVID-19.
Part of the return to work process will involve obtaining a health declaration for staff. This declaration seeks to confirm employees, or anyone in their household are not showing any symptoms of COVID-19 before they are permitted on site.
ABOUT THE DECLARATION
This declaration will outline key symptoms of COVID-19 and ask you to confirm you are not showing any of these, nor anyone in your household. In addition, if you are classed as a clinically extremely vulnerable person you should declare this in the relevant question. If you are unsure, please click here.
The declaration will also ask you to confirm that you agree to your details being submitted and held by this system.
Your details are held securely for the purpose of the health declaration only. Your details will not be shared with anyone outside of your employer or First Option site administrator.
If you have any concerns, please discuss either your main contact directly or our office email@example.com
To continue with the declaration, please select the button below.
CLINICALLY EXTREMELY VULNERABLE PEOPLE
Clinically extremely vulnerable people may include the following people. Disease severity, history or treatment levels will also affect who is in this group.
Solid organ transplant recipients.
People with specific cancers:
people with cancer who are undergoing active chemotherapy
people with lung cancer who are undergoing radical radiotherapy
people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
people having immunotherapy or other continuing antibody treatments for cancer
people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary (COPD).
People with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell).
People on immunosuppression therapies sufficient to significantly increase risk of infection.
Women who are pregnant with significant heart disease, congenital or acquired.
People in this group should have been contacted to tell them they are clinically extremely vulnerable.
If you are still concerned, you should discuss your concerns with your GP or hospital clinician.