COVID-19 Self Declaration Form for Visitors The purpose of this health declaration form is to determine whether you are at risk of contracting or currently have signs / symptoms of COVID-19. Name of person at the resort you are visiting.* Unit number (if known) Date of visit* DD slash MM slash YYYY Full name of visitor* Contact Number*Email* Address* Street Address City State Postcode How many ADULTS will be visiting Coral Beach Resort?* How many CHILDREN will be visiting Coral Beach Resort?* Please list each additional visitors name (first and last names)*Are any visitors experiencing any of the following symptoms: Loss of Smell, loss of taste, cough sore throat, fatigue, aches and pains, shortness of breath, runny or stuffy nose, headaches or raised temperature* Yes No Please list the visitor name/s and details of the symptomsHas any visitor been in a high risk Covid exposure venue on the designated dates and times* Yes No Please list the visitor name/s and provide more details of the situationTo your knowledge has any visitor been in close contact with a person who has been in a high risk Covid exposure venue on the designated dates and times* Yes No Please list the visitor name/s and provide more details of the situationHas any visitor been exposed to anyone that is suspected or confirmed to have COVID-19 within the last 14 days?* Yes No Please list the visitor name/s and provide more details of the situationDeclaration*I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform you of any changes therein, immediately. I understand further that I will advise Coral Beach Noosa Resort if any of my guests show symptoms or are diagnosed with Covid 19 following your departure.. I also understand that visitors to the resort cannot use any of the facilities of the resort. This includes the pools, spas and tennis court. Yes Full Name* Dated* DD slash MM slash YYYY This information is being collected for the purposes of Covid-19 mitigation and contact tracing, and will not be used for any other purpose. The information will be deleted 56 days after your departure. Coral Beach Noosa Resort follows the government health advice on operating in a Covid Safe environment. All visits to the resort are undertaken at your own risk.