Return to work for positive COVID-19 cases

Symptoms Assessment Form

The Symptom Assessment Form is to be used as part of the return to work for a positive COVID-19 case. This form is to be completed by the Employment Services Officer, Support Services Manager, Service Manager or Coordinator with the essential worker or non-essential worker.

Symptom Assessment Form
 
Date*
Non-essential or essential worker full name*
As stated on Medicare Card or Driver’s License
Have you received an SMS from NSW Health for the end of your 7-day self-isolation?*
Have you sent a screen-shot of your release SMS from NSW Health confirmation 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*
Isolation for non-essential and essential workers who have tested positive for COVID-19

Non-essential worker

Day 0

Isolation commences from the day of the positive PCR test result.

Day 7

NSW Health will send an SMS confirming the end of isolation.

Day 8 - 10

Avoid high-risk settings and wear a mask when interacting with people.

Day 11

A non-essential worker may return to work in a high-risk setting.

Essential worker

Day 0

Isolation commences from the day of the positive PCR test result.

Day 7

NSW Health will send an SMS confirming the end of isolation.

Day 8 - 10

For an essential worker, a return to work assessment and Symptom Assessment Form are to be completed before the return to work date is confirmed.

When can I leave Self-Isolation

Factsheet ‘Testing Positive for COVID-19’ NSW MOH 31/12/21

You must self-isolate for 7 days from the day you were tested. You can only leave self-isolation after 7 days if you do not have a sore throat, runny nose, cough or shortness of breath. You will receive an SMS from NSW Health after 7 days, but you do not have to wait for this SMS to leave self-isolation if it has been 7 days since you were tested.

Wear a mask when interacting with other people and avoid visiting high risk settings (health care, aged care, disability care or correctional facilities) for a further 3 days. If you work in one of these settings speak to your employer before returning.

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