CBAM COVID-19 Student consent

  • Dear Student: You have an upcoming course with CBAM. Please read the following consent form and initial and sign BEFORE you arrive to the course.

  • 1. I understand that the novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and that COVID-19 is extremely contagious and is believed to spread by person-to-person contact; and, as a result, social distancing is recommended. I confirm that I will follow the strict CBAM protocols on social distancing, safe working practice and infection control to minimize risk as much as possible to myself, colleagues and patients

  • 2. I understand that the Clinic management team is closely monitoring the COVID-19 situation and have put in place reasonable preventative measures aimed to reduce the spread of COVID-19. However, given the nature of the virus, I understand this is under constant review and as such my role may be subject to notified change and further training may be necessary.

  • 3. If at any time I become unhappy, or am concerned about safety I will immediately bring this to the attention of the manager.

  • 4. I understand that regular audits will take place to ensure that staff, students and patient safety is being maintained to the highest standard.

  • 5. I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. I accept the risk that I might become infected despite the safety measures that are in place. If I believe I could have been exposed to any risk, or could be infected I will stay home in isolation and immediately inform the manager.

  • 6. I confirm that I am not presenting with any of the following symptoms of COVOID-19 listed below at present: ∙ Fever ∙ Shortness of Breath ∙ Loss of Sense of Taste or Smell ∙ Dry Cough ∙ Runny Nose ∙ Sore Throat

  • 7. I am aware this can change, and as such I will immediately inform the manager should I develop any of the above symptoms, or if somebody I have been in contact with develops any of these symptoms/ or has to isolate.

  • 8. I understand that air travel significantly increases my risk of contracting and transmitting the COVID-19 virus. I confirm that I have not travelled in the past 14 days, and if I do travel or reside with somebody that travels I will isolate at home and inform the line manager.

  • 9. I confirm that if I develop COVID-19 symptoms or a known contact of mine develops symptoms and I am required to isolate, I will immediately inform the COVID-19 report line to enable contact tracing to commence.

  • I have read and agree with all the above statements in this consent form.
  • Date Format: MM slash DD slash YYYY