H202115435 Appendix.pdf

1982
Act
Information
Official
the
under
Released

link to page 3 link to page 4 link to page 6 link to page 9 link to page 10 link to page 11

1982
Act
Information
Official
the
under
Released

link to page 13

1982
Act
Information
Official
the
under
Released

link to page 13

1982
Act
Information
Official
the
under
Released

Document 3
Export of Daily Health Check Survey Questions as at 24 November 2021
Do you have any of the following symptoms?
Fever (feeling hot and cold)
Shortness of Breath
Cough
Sore Throat
Runny Nose
Loss of sense of smell
Do you have any of these symptoms?
1982
Headache
Act
Muscular Pain
Joint Pain
Nausea/vomiting
Diarrhoea
Information
Other (specify)
How are you feeling today?
Select an answer choice from the list
(same, better, worse)
Official
Do you have any health concerns?
Select an answer choice from the list  the
(yes/no)
Have you been eating/sleeping well?
Select an answer choice from the list
(yes/no)
under
Have you been outside for exercise or fresh air in the last 24 hours?
Select an answer choice from the list
(yes/no)
Please provide any further details
Question response text area
Released
Do you require welfare assistance?
Accommodation, Animal Needs, Cultural, Disability assistance, Family violence, Financial, Food,
Medical needs, Prescriptions, Support with children, Transport
Select an answer choice from the list
(Yes/No)
FINISH

1982
Act
Information
Official
the
under
Released