1. 1. Do you have a new, continuous cough? Yes/No
   2. Do you have a high temperature of 37.8C or over? Yes/No
   3. Are you experiencing a change or loss in your normal sense of taste or smell? Yes/No

1. 1. Have you or anyone in your household tested positive for coronavirus? Yes/No
   2. Are you still in the self/household isolation period? Yes/No
   3. Does anyone in your household have a new, continuous cough or a high temperature? Yes/No

1. Have you been advised by your GP to shield, as a clinically, extremely vulnerable person? Yes/No

Section 4 – Clinically vulnerable people (moderate risk)

• • • 1. Do you have a health condition which puts you in the clinically vulnerable, moderate risk of contracting coronavirus? Yes/No
      • • • • For example:
              o Pregnancy
              o Over 70
              o Diabetes
              o Underlying lung condition that is not severe, such as asthma
              o Heart disease
              o Liver disease
              o A condition affecting the brain or nerves, such as Parkinson’s
              o A condition which means you are at high risk of getting infections
              o Taking medicine that can affect your immune system, such as low dose steroids
              o have a BMI of 40 or above

Section 5 – NHS Test and Trace

1. 1. • • 1. Have you been contacted by the NHS Test and Trace that you have been in contact with a person with Covid-19? Yes/No

      Section 6 – Return to Work

      • • 1. Is anyone in your household currently shielding and therefore you are concerned about returning to work? Yes/No

        Return to work assessment conclusion:

        The completed assessments are kept securely in your individual driver’s file.

        Data collected by Zedcarz Group as part of the driver screening for COVID-19 will be held securely and will only be disclosed to individuals for the purposes of managing the health and wellbeing of our customers, staff and drivers.