Providing a service to a Covid Positive Client

In order for us to be efficient & effective when notified of a Covid Positive case in either a client or participant, we need you to advise if you are willing or unwilling to attend a positive case to provide services.

SW Name: *

Date * +

Region: *

Are you willing to attend a known client or participant that is Covid positive? *

Yes

No

Are you willing to attend a new or unknown client or participant that is Covid positive? *

Yes

No

Comments:

Date * +

SW Signature *

clear