Return to work for essential workers

Who have been identified as a high risk exposure to a positive COVID-19 case

This Assessment Form is to be used as part of the return to work for an essential worker who has been identified as a high risk exposure of a person who has tested positive for COVID-19. This form is to be completed by the Employment Services Officer, Support Services Manager, Service Manager or Coordinator with the essential worker.

Symptom and negative COVID-19 test Assessment Form
 
Date*
Essential worker full name*
As stated on Medicare Card or Driver’s License
Have you received a day-6 negative test result for COVID-19?*
Have you sent a screen-shot of your negative test result to COVIDcasereport@Sunnyfield.org.au*
Do you have a sore throat?*
Do you have a runny nose?*
Do you have a cough?*
Are you suffering from shortness of breath?*
Employment Services Officer, Support Services Manager, Service Manager or Coordinator’s name
Date of return to work*
When can I return to work (COVID-19 Exposure Risk Determination v1.2 31/12/21)

You must self-isolate for 7 days from the day you were informed you were a close contact, take a day-2 and day-6 PCR test and do a daily RAT test for the 7 days after your exposure.

If you are in a role essential to service delivery, provide a negative RAT test for each of the first 7 days following your exposure and do not have symptoms of COVID-19, your manager will speak with you and may be able to return to work as follows:

  • After 7 days AND
  • You have a negative test on day 6 AND
  • With a risk management plan for the next 7 days*

Your manager will consult with you to determine your suitability to return to work, and will explain the Risk Assessment to you. You are required to notify your manager and COVIDcasereport at the earliest possible time, if you develop symptoms of COVID-19.

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