Daily Health Check Consent

CONSENT

By submitting my personal (including health) information, I:

consent to My Occ Health Record collecting and sharing my information with my employer or other requestor of this collection for the purposes of maintaining a safe workplace and managing and preventing the transmission of COVID-19;

understand that I may decline to provide some or all of my information and have been advised of the consequences of doing so by my employer or other requestor of this collection;

understand that My Occ Health Record will not otherwise disclose my personal information without my consent unless permitted or authorised by law to do so;

confirm that I have raised any questions I have about this request with my employer or other requestor of this collection;

confirm that I will answer all the questions in the survey honestly and to the best of my knowledge; and

I acknowledge that My Occ Health Record is not providing a health service and taking the survey is not a substitute for medical advice.

IF, AND ONLY IF, YOU ARE BEING ASKED TO COMPLETE A RAPID ANTIGEN TEST, THE FOLLOWING ALSO APPLIES

I consent to a self-administered rapid antigen test to screen for COVID-19. I am aware this test is voluntary, unless otherwise stipulated by my employer. I am aware that this is a screening test only and not a diagnostic test. I am aware that if my screen shows that I may have been exposed to COVID-19, I will be asked to get a definitive COVID-19 test at a Public Health Unit and isolate at home until the results are known. I understand that the appropriate local authorities may be notified of my test result.

COLLECTION NOTICE

My Occ Health Record Pty Ltd (ABN 72 627 619 701) (My Occ Health Record) collects and processes the personal (including health ) information you submit in the online form to provide COVID-19 Support Services to our clients who are located across Australia and New Zealand, including your employer.

You should refer to your employer’s applicable policies and procedures for more about how and the purposes for which it collects your personal information, and whether it is required by any law to do so. If you do not provide some or all of the information requested it could result in disciplinary action.