STAFF COVID RISK ASSESSMENT

Name: Monica Daly

Staff to Answer ALL Questions Below:

1. How were you exposed

 In your Household? No
 By a COVID Positive Person? No
 By an exposure site during exposure period? Yes

2. Close Contact Definition

 Did you have Personal Interaction for 15 minutes or more? No
 Did you wear a mask? Yes
 Were you in close physical proximity? No
 Were you in an indoor setting? Yes

3. Do you have COVID symptoms? Yes

4. Have you been contacted by SA Heath to quarantine or get tested? Yes

5. Any PCR or RAT test completed?

 What was the result? Positive
 Can you supply evidence? Yes
 Date test completed? 13/05/2022
 Date result received? 13/05/2022

Please return form to lerwin@murraybridge.sa.gov.au with a copy of your test results.

Staff Return to Work COVID Risk Assessment

Form No 294 - (Version 1) Page 1 of 1