COVID-19 Declaration form for Contractors and Visitors

All visitors and contractors attending Yorke Peninsula Council offices and worksites are required to complete the following declaration prior to attendance.

Step 1 of 4

Are you a visiting a Caravan Park, or a Council site?*
- Caravan Park
- Council site
Which Caravan Park are you visiting?*
Where are you visiting from?*
- Interstate
- Intrastate
Company (If applicable)
Name*
First Last
Phone*
Email
Date of Visit / Commencement Date*
DD slash MM slash YYYY
Brief Description of Contractor Engagement or Visit*
Site of Work / Visit*
Site if other*
Council contact person*

Other travelling members

Please list all persons (adults and children) covered by this declaration

Name	Phone	Actions

There are no Members.

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Intrastate Travellers
Are you, or any other member of your travelling party, restricted/ prohibited from staying at the park under any current government COVID-19 regulations?*
- Yes
- No
Has any member of your travelling party had close contact with a positive case of COVID-19 in the past 7-days?*
- Yes
- No
Has any member of your travelling party visited a known COVID-19 High Risk location in the past 7-days?*
- Yes
- No
Are any members of your travelling party experiencing any flu like symptoms?*
Flu like symptoms may include fever, cough, sore throat, muscle pain, headache, breathing dificulty or pain while breathing
- Yes
- No
One or more of the answers you have provided may prevent you from accessing Yorke Peninsula Council worksites or Caravan Parks.

If you were planning on visiting a Caravan Park, please discuss with Muriel Scholz, Caravan Park Coordinator, on 0427 770 233. For all other worksites, please discuss with your nominated Council contact person on 08 8832 0000.

Please save your form below.

You will be asked for an email address and you will be emailed a link to resume this form later.

If this means face to face engagement is not possible, options may include meetings via video conferencing or phone.

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Guidelines and Preventative Measures

Face masks
Yorke Peninsula Council (YPC) require all visitors and contractors who enter a workplace to wear a suitable mask unless you have an exemption.

If you are feeling unwell
If you develop flu like symptoms prior to your visit, please do not attend. If you develop flu like symptoms during your visit please inform your council contact and seek medical advice. Please only return after you have fully recovered and been cleared by the Covid-19 hotline

Preventative measures
Continue to practice good personal hygiene at home, away and at any YPC worksite or Caravan Park. Encourage others to do the same.
Thoroughly wash your hands regularly with soap and water. This includes before eating, after using the bathroom, after blowing your nose, coughing or sneezing and after contact with animals.
Where washing your hands is not possible, please use sanitizer with at least 60% alcohol concentration.

Greeting each other
Please avoid shaking hands and other forms of touch. A smile, nod or wave can have an equal meaning.

Social Distancing
Keeping at least 1.5m from others, along with the other practices mentioned here can slow the spread of the virus.

Other measures
Beware touching surfaces which are frequently used by others
Wiping down surfaces after use
Cover your mouth if you cough or sneeze
Avoid touching your face, nose and mouth as much as possible
Avoid crowded spaces.
I agree to abide by the guidelines above*
- Yes
- No
Failing to agree will prevent you gaining access to Yorke Peninsula Council worksites.

Please discuss your concerns with your nominated Council contact person on 08 8832 0000.
Failing to agree will prevent you gaining access to Yorke Peninsula Council Caravan Parks.

Please discuss your concerns with your Muriel Scholz, Caravan Parks Coordinator, on 0427 770 233.
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COVID-19 Declaration form for Contractors and Visitors

Step 1 of 4

Interstate Travellers

Intrastate Travellers

Guidelines and Preventative Measures

Face masks

If you are feeling unwell

Preventative measures

Greeting each other

Social Distancing

Other measures

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