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Contact
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Admissions Creagh NS 2025
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Teachers Hub
Updated
Pre-Return to Work Questionnaire COVID-19 (PRW)
Creagh National School
This questionnaire must be completed by staff in advance of returning to work. If the answer is Yes to any of the below questions and you have not already done so, you are advised to seek medical advice before returning to work.
*
Indicates required field
Name
*
First
Last
Question 1: Do you have symptoms of cough, fever, high temperature, difficulty breathing, loss or change in your sense of smell or taste now or in the past 10 days? (2 days if recovering from Covid-19)
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Yes
No
Question 2: Have you been diagnosed with confirmed or suspected COVID-19 infection in the last 10 days?
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Yes
No
Question 3: Are you awaiting the results of a COVID-19 test?
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Yes
No
Question 4: In the past 10 days (5 days if fully vaccinated) , have you been in contact with a person who is a confirmed or suspected case of COVID-19?
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Yes
No
Question 5: Have you been advised by a doctor to self-isolate at this time?
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Yes
No
Question 6: Have you been advised to restrict your movements at this time?
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Yes
No
Question 7: Have you been advised to cocoon at this time? Note: if you’re at very high risk (extremely vulnerable) from COVID-19 you may be advised to cocoon.
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Yes
No
Declaration: I confirm, to the best of my knowledge that I have no symptoms of COVID-19, am not self-isolating or awaiting results of a COVID-19 test and have not been advised to restrict my movements.
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True
False
Please note: The school is collecting this sensitive personal data for the purposes of maintaining safety within the workplace in light of the COVID-19 pandemic. The legal basis for collecting this data is based on vital public health interests and maintaining occupational health and this data will be held securely in line with our retention policy
Submit