[PF-ID] Template: Visitor Screening Log

Written by Rose Lam | May 30, 2021 12:00:54 PM

Visitor Screening Log

During an early, less severe stages of a Pandemic where the country has not yet initiated lockdown and most organizations have not initiated Remote Working policies, worksites will be still be receiving visitors. Offices will be meeting with their clients, hospitals and nursing homes will be allowing visitors into their premises, and so on.

However, there's no telling whether these visitors could be carriers of the infectious disease. Thus, in order to safeguard the health of the employees, a screening station should be set up outside the premises of the worksite, along with PPE-equipped staffers trained to screen visitors, as well as to help them fill out the Visitor Screening Log.

The purpose of the Visitor Screening Log is to prevent the spread of influenza via screening visitors to determine, among other things, whether have any symptoms, whether they been to any high-risk countries recently, and/or whether they have any contact with patients affected by the disease recently. Even in the event that visitors are asymptotic, the Visitor Screening Log also serves as a useful tool for contact tracing.

Visitor Screening Log Sample Template

Dear Sir / Madam

To prevent the spread of Influenza in our community and reduce the risk of exposure to our staff and visitors, we are conducting a simple screening questionnaire. Your participation is important to help us take precautionary measures to protect you and everyone in this building. Thank you for your time.

Visitor’s Name:

 

 

Telephone Number:

_______________(HP) _______________ (O)

_______________ (H)

NRIC/ Passport No.:

 

 

Nationality (For Foreign Visitors only):

Meeting Venue/ Level:

 

 

Name/ Department of Officer:

 

 

Telephone Number:

 

Temperature Reading (Recorded by Staff): __________oC

 

Declaration

  

1

If you are the following symptom(s), please tick the relevant boxes

  •  Fever                                  
  •  Dry Cough                          
  •  Runny Nose                        
  •  Body Aches
  •  Tiredness
  •  Headaches
  •  Others:

2

Have you been in contact with a confirmed influenza (H7N9/MERS-CoV) patient in the past seven days?

  •   Yes
  •   No

3

Have you been to (to following country(s)/ area(s)) in the past seven days?

  •  Yes: List of countries to be selected]

 

  •  No

 

 

 

Signature:________________________                  Date:_______________

 

 

Reference Guide

Goh, M. H. (2016). A Manager’s Guide to Implement Your Infectious Disease Business Continuity Plan, 2nd Edition. GMH Pte Ltd.

Do You Want to Continue Training During A Pandemic Outbreak?

Due to the pandemic outbreak, BCM Institute will be conducting its certification courses via interactive video conferencing, online and e-learning mode. Find out more about the Business Continuity Management (BCM) and Crisis Management (CM) Blended Learning (BL) courses.

For this period, the content will include the managing and implementing of the Pandemic Influenza plans.

 
View full post