Covid 19 Health Assessment

Your Covid-19 Health Assessment

At Bazely & Co, we are committed to ensuring we provide a safe environment for our employees and for all of our customers. We have taken several measures to protect against the spreading of COVID-19, which includes a health assessment on customers who have requested to meet us, or one of our sellers.

Your First Name

Your Last Name

Telephone

Address
Please enter your post code below, or enter your address manually

Address 1

Address 2

Town/City

County

Postcode

Work Type Of Appointment Would You Like To Book?

Address Of Property You Wish To View Or Have Valued (leave Blank If Entered Above)

Are You, Or Any Person, In Your Household Currently Self-isolating Due To COVID-19?

Are You, Or Any Person, In Your Household Showing Any Symptoms Of COVID-19?

Have You, Or Any Person, In Your Household Been Advised By The NHS That You Are Classed As A Vulnerable Person?

Have You, Or Any Person, In Your Household Recovered From COVID-19?

Are You Classed As An Essential Worker?

Date Form Completed

IF ANY OF THE INFORMATION ON THIS FORM CHANGES PLEASE ENSURE YOU CONTACT US IMMEDIATELY

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