Coronavirus (COVID-19) workplace outbreak notification form

If you would like speak to someone regarding completing this form, please call 01442 228284.

Business details

Name of business

Type of business (business activity)

Business setting

For example, office, warehouse, retail etc.

Business address

Please include postcode if known.

Number of cases

Date of positive test for first known case

Date of positive test for most recent case

Date of positive test for subsequent cases (list these below)

Name

Telephone number

Mobile number

Email address

We process your information in accordance with the UK GDPR and Data Protection Act 2018.

For more information, please see our privacy policies.

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