Your Covid Test Result (Regal Road)

Ascot Avenue Community Daycare at Regal Road Junior Public School

Dear Employee

Please ensure to complete this form on Monday and Thursday prior to the start of your shift.
Name Name * First Last
Center name *
Supervisor name *
Date Date * / MM / DD YYYY
Test result *
Disclaimer:

I attest that the information regarding my test result is true and accurate. I understand that if my test result is positive I need to adhere to the following guidelines:
• Positive test result is considered a preliminary or presumptive positive. Anyone who receives a preliminary positive result must:
• Inform my supervisor immediately.
• b) Seek confirmation through a lab-based PCR test or rapid POC molecularst as soon as possible (ideally within 48 hours)
• c) Isolate until the results of the lab-based test are confirmed
Signature ( Enter your full name) *