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WDHS Request for Quarantine Exemption
Please fill out the form and your submission will be sent to the Chief Executive to review
3Questions
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  • 1

    Exemptions


    Workers who are close contacts (meaning household or household-like contacts) may be exempt from quarantine requirements in order to attend work - so long as conditions are met, and their attendance is necessary for continuity of operations.

    Who does this apply to:

    Those who are close contacts who have no symptoms

    What does the exemption cover?

    Allows the staff member to work onsite with conditions but when the staff is not at the workplace staff must otherwise comply with all quarantine requirements.

     *Please note these conditions are subject to change as directed by the Department of Health & Human Services

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  • 2
    • IPC Monday to Friday 8am – 4:30pm • HBH AH Coordinator after 4:30pm weekday or weekends & public holidays Infection Prevention and Control Team contact number 5551 8246
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    Please contact Infection Prevention and Control Team on 5551 8246 to discuss.

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  • 7
    Please make sure the email is correct
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  • 8
    Please change
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  • 9
    eg. is the staff member able to isolate from the infected house contact
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    Personal email is preferred so that you can be contacted about your request. If no email please
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    Conditions upon approval

    If you are given approval to work onsite at Western District Health Service staff must

    • undertake a daily rapid antigen test for 5 days and return a negative result prior to commencing work;
    • wear an N95/P2 face masks at all times while at work and while travelling to and from work;
    • must not enter shared break areas with other workers; and
    • must not share facilities or amenities with other staff if possible, and follow all employer directions if they must use shared facilities

    You will need to complete Rapid Antigen Testing and report any positive results using the WDHS Rapid Antigen Testing Reporting form. This form can be accessed on your phone or from home on the WDHS website under Staff Links section (bottom of page).

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