Food Handling Staff Illness Reporting Agreement in Food Production

Food Handling Staff Agreement to Report Illness

  1. Any of the following illness symptoms;
    • Vomiting
    • Diarrhea
    • Inflamed skin problems (Bullae (blisters), even if small, inflamed wounds)
    • Discharges from ear, eye, nose, and other areas
  2. Any of the above-mentioned illness symptoms during vacation/leave
  3. Diarrhea and/or vomiting in any family member (while I am working or during vacation/leave)
Employee Name, Surname:
Employee Signature:
Company:
Date:

This form will be prepared in 2 copies, one copy will remain with the employee.

I agree to report my condition without delay to my Department Manager / Supervisor if any of the following conditions occur.

I have read (or it has been clearly explained to me) the above and accept the company's personnel hygiene rules.

Form No: FSA ISIS_Food_Safety_Forms_2019