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Site Sign-In and Contact Tracing
 



Please complete this form to record you have attended the site today.

You are required to complete this sign-in prior to entering the site.

You must complete it for each Melbourne Architectural Constructions Pty Ltd site you enter.

 



Declarations
 
Permit to Work

I confirm having a completed 'Permitted Worker' form to work in Melbourne.

Please note that permits are only required for sites within Melbourne under stage 4 restrictions.
 *
 Yes
 No
 Not Applicable

If NO, you are not permitted on site.
 
Work Patterns | Travelling Between Sites

I confirm that I have been working at more than one site within the last 7 days.
 *
 Yes
 No

Where yes, please provide below, the details of all the sites you have worked on in the last 7 days (Date | Builder | Address):

For example:

Job 1 - 12/08/20 | John Smith Builders | 10 Smith Street, NOWHERE.

Job 2 - 09/08/20 | Jane Doe Builders | 1 Down Ave, EVERYWHERE.
 





Please complete the following fields

Employer / Company (Who you work for)
*

Visitor name*

Visitor phone*

Date*

Time*

Venue name*

Venue Address*

Location Description/Type*



Notes:

1. The data will be retained by the State of Victoria for a maximum period of 28 days to assist employers’ compliance with workplace directions issued under section 200 of the Public Health and Wellbeing Act 2008 (Vic) with respect to COVID-19 or related matters (Workplace Directions).

2. Similarly, your personal information will only be kept by Melbourne Architectural Constructions Pty Ltd for 28 days.