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Mitti by SafetyCulture
Template

COVID-19 Jobsite Visitor Questionnaire

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This COVID-19 jobsite visitor questionnaire helps screen visitors before entering a worksite. It captures project and visitor details, date, reason for visit, health and safety officer, and location. The form asks about confirmed COVID-19 diagnosis, recent symptoms such as fever, cough, shortness of breath, sore throat, muscle aches, and loss of taste or smell, and recent exposure to confirmed or symptomatic cases, including recent travel exposure. It concludes with sign-offs from the health and safety officer and the visitor to document acknowledgement. Use this template to standardize screening and support safer site access control.

With Mitti you can

Digitize any process, procedure or policy
Eliminate mistakes made by paper-based processes
Create and share professional reports instantly
Confirm accountability and compliance with a digital log

With Mitti you can

Digitize any process, procedure or policy
Eliminate mistakes made by paper-based processes
Create and share professional reports instantly
Confirm accountability and compliance with a digital log

About author

Mitti (by SafetyCulture) is the operations system for every site, shift and standard. Trusted by over 80,000 organisations, Mitti brings your people, operational data and workflows into one operating picture. From the frontline to the boardroom, it gives everyone a clear understanding of what's happening, highlights what needs attention and recommends what to do next. Every inspection completed, issue raised and action taken becomes intelligence your teams can use to improve every day.