Team Return To Work

Dear  Clinicians and Staff members 

We take the health and safety of our teams very seriously. This is particularly the case because we are considered critical workers and have a duty of care to ensure safety of our family and our patients.

Prior to reopening to routine patient care, we would like all of you to complete this form so that we are aware of your current relevant medical status, opinions and risk level with regards to coronavirus infection.

It is important that you have thoroughly read, understood and agree to abide by the latest Standard Operating Procedure of 1st June 2020 prior to completing this form.

Please complete as thoroughly as possible as you will not be permitted to start work until this has been completed

If you have any questions please refer to our practice manager or clinical directors

Thank you for your co-operation.

Keep Safe, Keep Well and Keep Alert

Return to Work Declaration
1) IMPORTANT : In the last three weeks have you been in communication with someone who has or may may have COVID-19 (coronavirus infection) or had any of the following? PLEASE TICK ALL THAT APPLY.

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