Track and Trace – Plastribution Group

Coronavirus: Track & Trace Form

Plastribution is monitoring developments regarding the COVID-19 virus closely. Out of concern for the wellbeing and safety of you and all employees and visitors, we ask that you monitor your health status by carefully completing this self-assessment form prior to visiting our offices.

Please only complete this form within 24 hours of your visit.

When you do arrive on site, please make use of the hand sanitiser stations in our lower reception area and please ensure you are wearing a face mask when entering the building and in all of our communal areas. Thank you.

Track and Trace Information

Name*

Company*

Email address*

Contact Telephone Number*

Date of Visit*

Purpose of Visit*

Your Host/s (Who are you coming to visit?)*

Health Check

Have you recently experienced fever-like symptoms such as a cough, shortness of breath or high temperature ?*

*As you have answered yes to this question, please do not visit our site. Follow NHS guidance on self isolating and order a test to confirm whether you have COVID-19.

Have you recently had contact with anyone that is/are confirmed or suspected of having fever or flu like symptoms ? *

*As you have answered yes to this question, please do not visit our site. Follow NHS guidance on self isolating and order a test to confirm whether you have COVID-19.

Do you agree to show Plastribution your NHS Covid Passport on arrival, showing evidence of full vaccination and/or proof of a negative COVID-19 test result?*

Details of the NHS Covid-19 Passport can be found on the NHS website

Would you be willing to conduct a Lateral Flow Test on site?*

Details of the NHS Covid-19 Passport can be found on the NHS website

* Please contact your host prior to arrival

Have you been outside the UK in the past 14 days ? If yes, please list the country/countries visited.

Please type the characters*

This helps us prevent spam, thank you.

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