COVID-19 Attendance Register Date* DD slash MM slash YYYY Name* First Last Phone Number*Office Attended*Please selectMelbourne CBDBroadmeadowsHeidelbergSunshineMoorabbinPlease selectCheck-in Time* : Hours Minutes AM PM Relationship to Doogue + George*Please select one Client Dependent (to be completed by parent or guardian) Employee Contractor Visitor Areas visited within Doogue + George*Please select all that apply Reception Lawyer Office Boardroom (small) Conference Room (large) Bathroom Are you or anyone attending with you feeling unwell?* Yes No If so, do you have a cough or flu-like symptoms?* Yes No Have you, anyone attending with you, or anyone you know tested positive for COVID-19?* Yes No If yes, when?* DD slash MM slash YYYY If you answer yes to any of these questions, you must advise us immediately and leave the office. We will make alternative arrangements to meet with you. COVIDSafe Declaration Please read the following and check the box: I am healthy and well and have no symptoms of any illness. I have not been instructed or advised to self-quarantine in the past 14 days. I am not aware of any personal contact with a case of COVID-19 in the past 14 days. I will follow all directions by staff of Doogue + George including physical distancing guidelines and mandatory wearing of masks. Consent* I agreePrivacy Doogue + George are collecting this information under government directions. This data will be held for 28 days and subsequently deleted. Δ
