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Maintenance & inspections health declaration form

In the interest of protecting the health and well-being of our clients and staff, prior to entering an occupied home, we are required to ask you questions related to your health and travel activities so that we can all do our best to prevent the spread of COVID-19 in our community.

I Agree to Covid-19 Declaration*
You do not have any symptoms associated with Covid-19 (e.g. fever, cough, sore throat, shortness of breath, sneezing, runny nose, loss of sense of smell, etc)
You do not have Covid-19 nor are you awaiting the result from being tested for Covid-19
You have not been in contact with any known or suspected cases of Covid-19 in the past 14 days
You have not returned or been in contact with anyone else who has returned from overseas in the past 14 days.

Tick this box if you would not like to receive our newsletter and other communication.

I understand that this information will be handled in accordance with Orbit Homes’ privacy policy and it will be supplied to the government if required for COVID-19 contact tracing purposes. in-line with the Victorian Government’s COVID-19 restrictions, I accept these terms and declare the truthfulness of the statements above.