I agree that if myself, a member of my household or another close contact, suffer from any of the following conditions of ill health (including if contracted abroad), I will inform the HR Department prior to commencing normal duties with Albert Bartlett. 

• Serious diarrhoea and/or vomiting
• Impetigo (bacterial skin infection characterised by small pus-filled blisters)
• Septic cuts, boils and nail infections
• Dermatitis or eczema of the hand, arms and/or face
• Psoriasis, rashes or any other skin conditions
• Parasitic infections (Malaria, Tapeworm or such like)
• Bacterial food poisoning e.g. suspected or confirmed salmonella
• Discharge from wounds, abscesses, ears, nose, throat, mouth or eyes

If I have suffered from vomiting and/or diarrhoea, I fully understand that I must be free of symptoms for at least 48 hours without medication prior to returning to work. Otherwise clearance must be sought from the Human Resources Department and/or Medical Practitioner.

I realise that I may be required to provide additional information if a Company risk assessment determines that there is a real risk to food safety and/or public health.  I also understand that in the above case or where I suspect I may be suffering from food poisoning, I should consult my own GP (Doctor) for confirmation and clearance to return to work.

I have read this document (or had it explained to me) and I fully understand the Personal Hygiene procedure as well as ’Site food safety and hygiene practices – QC policies’.  I agree to abide by all Company Rules and Practices in relation to Food Hygiene and Personal Hygiene.

By clocking in you are declaring you free from any of the above symptoms listed above and fit to work

I fully understand that if information is withheld, suppressed or deliberately misleading or false, it may be considered a disciplinary matter. 

Company Signature - L.Hutchinson Date -