Guest Declaration Form – COVID-19 (Please complete at checkin) Welcome to The Islander Noosa Resort. Thank you for supporting us to keep you, other guests and our staff safe. The purpose of this health declaration form is to determine whether you are at risk of contracting or currently have signs or symptoms of COVID-19. Name* First Last Address* Street Address City State Postcode Email* Arrival Date* Date Format: DD slash MM slash YYYY Departure Date* Date Format: DD slash MM slash YYYY Please list names of all the guests in your group/ family staying with you (first and last name)*Q1 Are any of the guests in your group/family 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 temperatures?*YesNoQ2 Have any of the guests in your group/family been outside of Queensland in the past 14 days?*YesNoQ3 Have any of your guests in your group/family been in close contact with a person who has returned to Australia in the last 14 days?*YesNoQ4 Have any of the guests in your group/family been exposed to anyone that is suspected or confirmed to have COVID-19?*YesNo If you have answered yes to any of these questions, we will need to take each guest’s temperature. If your temperature is above 37.5 degrees, then we will have to refer you to Queensland Health. Declaration*– I will advise The Islander Noosa Resort if any of my guests in my group/family show symptoms of, or are diagnosed with COVID-19 in the 14 days following our departure. – I certify that the information above about my group/family is accurate to the best of my knowledge. – I acknowledge that I am responsible for my group / family’s health, wellbeing and safety and that I will follow Qld Health Directions and comply with any procedures or instructions provided by management for The Islander Noosa Resort.YesNoDate* Date Format: DD slash MM slash YYYY Thank you. 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. All travel is taken at your own risk. PLEASE NOTE: Upon check-in, you will be required to sign this form at Reception to confirm that all the information declared is still relevant and accurate.