Client Health & Safety Form - Change Recruitment Services Ltd & Change Recruitment Services (Taunton) Ltd

Company Name *

Your Name *

First

Last

Position within the Business *

Are there any known health and safety risks for this role? If yes, please detail along with actions taken to reduce these risks. *

Have any staff members of your business been diagnosed with Coronavirus, or had to self-isolate in relation to Coronavirus? If yes, please provide dates for each case and if they have subsequently returned to work *

Please provide details on your policy in relation to the Coronavirus pandemic so we can share this with any temporary members of staff. (including social distancing measures we will need to make the candidate aware of if working from your site) *