ENQUIRE ABOUT HEALTH SCREENING
REQUEST CONFIDENTIAL HEALTH ADVICE
TRADE UNIONS WORKING TO PROTECT THE
HEALTH OF CONSTRUCTION WORKERS
TRADE UNIONS WORKING TO PROTECT THE
HEALTH OF CONSTRUCTION WORKERS
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HEALTH SCREENING
SITE SURVEY QUESTIONNAIRE
CWHT SITE SURVEY QUESTIONNAIRE
For the attention of the Site Safety Manager/ Safety Officer
Please leave blank:
Contact Information:
Main Contractors Name:
Site/Project Name:
Site Address:
Expected Start Date:
Expected Finish Date:
Site contact name/s:
Mobile No/s:
Email Address:
Number of workers expected to partake:
Normal site start time:
Normal site finish time:
Can you please give detailed directions to your site:
Setup Information:
Can our driver setup screening room one day before and remove equipment on the last day of screening?
Yes
No
Is there car parking available for our staff?
Yes
No
Will site induction be required for our nurse/s?
Yes
No
If yes to the above, please provide induction duration and location details, as well any further information that may be required.
Are there any Covid-19 requirements apart from standard HSE requirements?
Yes
No
If yes please contact CWHT on
01 709 3070
Will our nurse/s require a security pass?
Yes
No
If yes to the above where can these be issued?
Screening Facilities:
Will the screening room have a large table/desk and two chairs with access to plug sockets?
Yes
No
Is Wifi available on site?
Yes
No
Will the room be well ventilated with cooling/heating?
Yes
No
Will there be a suitable waiting area outside the room?
Yes
No
Can the room be locked overnight?
Yes
No
If no, will our equipment be secure?
Is there access to toilets and drinking water nearby?
Yes
No
Will there be parking spaces available for our nurse/s:
Yes
No
Will there be canteen facilities on site?
Yes
No
Who should our nurse/s contact in the event of an emergency?
Are there any special conditions or access arrangements relating to this site?
All correspondence or site related queries regarding health screening to be discussed directly with CWHT
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