Covid Safe Declaration Form. | l-h-installations

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Covid Safe Declaration Form.
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Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

Address

Email

Nobody within my household is experiencing the symptoms: fever, cough, sore throat and is or self isolating in the last 14 days.

Nobody within my household has been in close contact with a Covid-19 patient in the last 14 days

Nobody within my household has returned from abroad in the last 14 days.

I/We agree to a contactless visit and will isolate to another part of our property for the duration of the visit, if contact is required the wearing of a face covering at all times for the duration of the visit whilst in comminucation with any tradespeople and agree to keep a minimum of 2 Metre Social Distancing at all times.

I/We agree to prior to the visit that all surfaces and areas that we may come into contact with in the main area of works (including stair rails/door handles internally and external are cleaned.

I/We will arrange for areas to be worked in to be well ventilated by opening a window and all doors are left open to minimise touching of handles

I/We agree that should any above symptoms develop in the interim or whilst L H Installations or associated trades are working in my proprerty, I/We will noitify L H Installations with immediate effect.

I/We agree to minimise traffic to any rooms being worked in, along with keeping traffic to a minimum through entrance ways, hallways, landings or the main route the tradespeople are to use whilst working in my property.

I/We understand that any parts or materials that I/We are to supply for the tradespeople will be left in the area to be worked in prior to the visit taking place.

I/We agree to keep all pets away and either isolated or put on a lead where possible.

I/We agree to keep all children supervised at all times and that they are kept away from working areas.

I/We agree to have a suitable device such as a mobile phone available and charged to be able to dicuss the work remotley between each other if required.

I/We agree that nobody else will enter the property that is not part of our immediate household ie another tradesperson/member of family or friend unless prior arrangement is agreed.

I/We agree that a temporary barrier maybe put into place for the duration of work and agree to not enter this area during or at the end of day after tradespeople have left for the day for a room that is being worked in for consecutive days to ensure the area continues to be covid safe. This will mean no access until work is complete and we therefore request all belongings required are removed from the area prior to work commencing. I /We will agree to respect this barrier at all times.

Available accepted payment at this time.

Bank Transfer/Bacs

Debit card

Credit Card

Apple Pay

Failure to comply with the items listed above, will regrettably mean that we will be forced to leave site until the issue is resolved, even if this means that your property is left disrupted or without services.

I/We accept terms & conditions and confirm that all members of the household are or will be made aware of the conditions required for the visit or works to be carried out.

I declare that the info I’ve provided is accurate & complete

Date

Your Signature

We do appreciate Our Customers and it is always nice to have a chat whilst visiting, however to help reduce transmission, we ask for conversation to be kept minimum and do not wish to come across as rude. We thank you for your support and understanding at this time.

Thanks for submitting!

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