CONTACT TRACING REGISTER - NSW

Dear Valued Guests

By completing this form you acknowledge that:

• You do not have any symptoms associated with COVID-19
• You do not have COVID-19 nor are waiting the results of being tested for COVID-19
• You have not been in close contact with someone who was diagnosed with or is suspected of having COVID-19 in the past 14 days
• You are not required to self-isolate due to your travel history

Your privacy is important to us. The information that you provide in this form will be kept in accordance with all applicable laws and used for the purpose of contact tracing at the request of the New South Wales of Federal Government (including and public health agency) or as otherwise legally required. Please note that we will securely retain this information for a period of 30 days after which time it will be securely destroyed.