Resident Health & Safety Form

Resident Health & Safety Form

This form is crucial for ensuring your safety while at Cove Park, collecting essential emergency contact details and relevant health information. Providing this data ensures we can act efficiently in any emergency.
- Full Name
  
  First NameLast Name
- Mobile Phone Number or What's App
  
  Country CodeArea CodePhone Number
- Email Address
  example@example.com
- If you are not a citizen of the UK, we may need to get in touch with your country's embassy in the event of an emergency.
- Name listed on your passport:
- Issuing Country:
- Passport number:
- During you residency you may be invited to lunches or dinners with other residents or to special catered events organised by Cove Park's team. The kitchen in the Jacobs Building is also a communal, shared space and therefore it is vitally important for us to know if you have any anaphylactic allergies that would require emeregency medical care if you come into contact with specific food items (including but not limited to peanuts, sesame, and shellfish).
  
  Please note, our 50-acre site is home to a flock of sheep and three Highland cows. From time to time dogs belonging to members of the team are also on site and in the offices of the Jacobs Building. Please also let us know if you have a serious pet allergy.
- Do you have an anaphlyactic food allergy?
- Please list any allergies and food intolerances here:
- Do you have a pet allergy?
- If yes, please provide more details:
- Do you have any mobility, medical, or sensory needs that may require assistance during evacuation?
- If yes, please describe your needs and the type of assistance required:
  This information is used only for emergency procedures and will remain confidential amongst the Cove Park team.
- Preferred evacuation assistance (select all that apply)
  
  Other
- Any additional information or special instructions for your evacuation plan:
- Emergency Contact Name
  
  First NameLast Name
- Emergency Contact Phone Number
  
  Country CodeArea CodePhone Number
- Relationship to you:
  Ex: partner, sibling, parent, etc.
- If the person above is not available in case of an emergency, who else can we contact?
- The information supplied in your application will be processed in accordance with current Data Protection legislation. A digital copy of this form will be shared with the selection panel in order for them to read your submission as part of this process. See our Privacy Policy for full details of why and how we process your personal data and your rights under the General Data Protection Regulation (GDPR).
  
  If you have any questions or concerns about this, please get in touch with Senior Producer Alex Marrs.
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