COVID Vaccine Declaration

"*" indicates required fields

In response to the Victoria Government's announcement that all construction workers are required to be vaccinated for COVID-19, Apex Pools and Spas are requesting you to complete the below information to ensure we keep our job sites safe.
Please ensure that when providing this information, you have complied with consent obligations as per the Privacy Act 1988. Please note, we are only storing vaccination details for the purposes of complying with health orders.
Consent*
I consent to providing Apex Pools and Spas with the below Vaccination Declaration Information
Vaccination Status
Please select the status that best describes your current vaccination status
Advise the date or planned date of your 1st Vaccination Does (if applicable)
MM slash DD slash YYYY
Advise the date or planned date of your 2nd Vaccination Does (if applicable)
MM slash DD slash YYYY
If you have selected 'No' to Consenting for to this information to be received or wish not to receive the COVID19 Vaccine, please provide reasons for this below.
Acknowledgement*
By checking the Yes box below, you understand that the information you have provided is true and correct and if necessary Apex Pools and Spas may request evidence of your vaccination.
Max. file size: 128 MB.
Have you completed the COVID-19 Infection Control Training to become a COVID Marshal?*