Mnu MNU

COVID-19 Contact Tracing Form

 

 

 

Contact tracing form

During Alert Level 2, this information is being collected to assist in the management of the Covid-19 pandemic. It will be given to the Ministry of Health and/or the District Health Board on request if it is required for contact tracing purposes. We will not use it for any other purpose and will destroy it after four weeks.

It will be kept here at Sanctuary Mountain Maungatautari. You have a right to access and correct any information we hold about you.

To do this SMM will keep a register of:

  • All people, both workers and visitors, entering or leaving the workplace.
  • All people that workers have contact with while conducting their work.

COVID-19 contact tracing entry

Full name*
Are you a machine? If not please enter nothing in here:
Email address*
Phone number*
Address
Areas visited*