AGREEMENT TO REPORT INFECTION To be completed by all food-handling staff on appointment and retained in their personnel file I agree to report to my immediate supervisor or manager as soon as possible, by telephone if necessary, in any of the following circumstances: Should I suffer from illness involving any of the following: a. Vomiting b. Diarrhoea c. Septic skin lesions (boils, infected cuts, etc.) d. Discharge from ear, nose, eye or any other body location 2. Before returning to work following any illness with the above conditions. 3. Should any of my household be suffering from diarrhoea and/or vomiting. 4. returning from any holiday during which I suffered diarrhoea and/or vomiting. 5. returning from any holiday in which any of my party suffered diarrhoea or vomiting. I have read (had read to me) the "Personal Hygiene" Handlers Clothing” and Washing & “Food “Hand Gloves” processes and received a copy of Sodexo’s Hygiene Notes’. ‘Personal I understand and agree to abide by those standards. Signature: Date: Name (in Job title: capitals): Name of manager issuing documents: Signature & date:
AGREEMENT TO REPORT INFECTION To be completed by all food-handling staff on appointment and retained in their personnel file I agree to report to my immediate supervisor or manager as soon as possible, by telephone if necessary, in any of the following circumstances: Should I suffer from illness involving any of the following: a. Vomiting b. Diarrhoea c. Septic skin lesions (boils, infected cuts, etc.) d. Discharge from ear, nose, eye or any other body location 2. Before returning to work following any illness with the above conditions. 3. Should any of my household be suffering from diarrhoea and/or vomiting. 4. returning from any holiday during which I suffered diarrhoea and/or vomiting. 5. returning from any holiday in which any of my party suffered diarrhoea or vomiting. I have read (had read to me) the "Personal Hygiene" “Food Handlers Clothing” and “Hand Washing & Gloves” processes and received a copy of Sodexo’s ‘Personal Hygiene Notes’. I understand and agree to abide by those standards. Signature: Date: Name (in capitals): Job title: Name of manager issuing documents: Signature & date:
SMS_QAL_GU_003a_Agreement%20to%20Report%20Infection_V1.docx