Has someone on your site reported a positive test result for COVID-19?

If someone on your work site, or at your workplace has reported a positive test to COVID-19, fill out the following form.

While we expect employers to put all necessary measures in place to prevent the spread of this virus, we want to make sure we can support you if someone on your site reports a positive test result to COVID-19.

If you believe the risk of the spread of COVID-19 is not being managed adequately on your site, or at your workplace, contact the Safety Hotline on (08) 8231 7424 or contact your organiser.

Personal information provided in this report will remain confidential.

* indicates a mandatory field.

Your Details

Your Name *

Member Number *

Contact Number *

Site Details

Your Employer *

Project/Site Name where the person reported a positive test to COVID-19 *

Project/Site Address where the person reported a positive test to COVID-19 *

When was the positive test result communicated to you? *

Year

Month

Day

In the two weeks prior to the person reporting a positive test result for COVID-19, how many days were you exposed to the person? *

In the two weeks prior to the person reporting a positive test result for COVID-19, how many hours a day (average) were you exposed to the person? *

Have you been exposed to any other person who has a confirmed case of COVID-19? *

Yes