COVID-19 Form

Do you have a fever of 38* (or higher)
Do you have a cough?
Are you suffering from breathlessness?
Have you a sore throat?
Have you any other symptoms?
Have you or any immediate family member come in close contact with a confirmed case of the coronavirus in the last 14 days?

Thanks for submitting!

 

This document will be retained confidentially by Corrib Gym for two months after submission.
The health and wellbeing of our community is our first priority therefore Corrib Gym reserves the right to deny entry to the premises.
Private Data Protection Notice: We are collecting and processing this personal data on the basis of Art. 6 (1) (f) and Art.9 (2) (i) Regulation (EU) 2016/679 (“GDPR”). We do this as preventive measures for our community to mitigate the risk of a novel Coronavirus disease (COVID-19) outbreak at our centre. Also, we are collecting personal data to be able to support local authorities in case of an outbreak in Ceantar na nOileán area. In such a case, the data will help the authorities to trace a human -to-human transmission of the Virus. This data sheet will be stored confidentially and is not shared with any third party, unless there will be an official request by the local authorities for reasons of public interest in the area of public health. The datasheet will be deleted two months after collection, unless a longer period is required by the public authorities. Thank you for your cooperation!