food_handlers_return_to_work_questionnaire.doc - UCL HUMAN...

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UCL HUMAN RESOURCES DIVISION OCCUPATIONAL HEAL TH SERVICE UCL Occupational Health Service University College London Gower Street London WC1E 6BT Tel: +44 (0) 20 7679 2802 Fax: +44 (0) 20 7209 0256
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FOOD HANDLERS RETURN TO WORK – FITNESS TO WORK QUESTIONNAIRE This form must be completed by all food handlers on return to work following absence due to illness. Name Of Employee Address Tel No Job Title Yes No 1. Do you suffer now or have you over the last 48 hours suffered from diarrhoea and/or vomiting? 2. If no, have you in the last 48 hours taken any medication to control diarrhoea and/or vomiting? 3. At present are you suffering from: a) Skin trouble affecting hands, arms or face? b) Boils, styes or septic fingers? c) Discharge from eye, ear or gums/mouth? Signature of employee Date For office use only Guidance note to Manager/Supervisor If the answer to any of the above is yes the individual should not be allowed to handle food.
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  • Spring '15
  • It, University College London, London Gower Street, Occupational Health Service, UCL Occupational Health Service, UCL Occupational Health, College London Gower

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