Visitors Entry Questionnaire
This questionnaire must be completed by all visitors to the site.
Date:
Full name:
Company name:
Purpose of visit:
Mobile number:
E-mail address:
QUESTIONS YES NO COMMENTS
Do you suffer from any of the following conditions currently or during the last 2 weeks?
Food poisoning, Diarrhea, Vomiting or any other stomach or
bowel disorders.
Fever, pneumonia, sore throat or very bad cold / flu.
Hepatitis / Jaundice
Any kind of allergy
At present:
Are you suffering from any infections of the skin, hands, arms or
face (e.g. boils, septic fingers, discharge from eye / ear / gums / mouth.)
Have any open wound or a graze/scrapes.
Have you recently traveled from abroad where any food borne
diseases are prevalent?
Have you been Covid-19 positive?
If yes, please specify both the dates when you tested positive and
when you already came negative
Have you completed the Covid-19 vaccination doses?
If yes, please specify the date of second dose completion
Are you carrying any of your personal belonging like mobile or
any object(if yes, counter signature from HFL designated Person)
Signature :
I certify that to the best of my knowledge the answers given above are true and complete. I agree to follow the Food Safety Standards of Hunter
Foods L.L.C during our appearance in the production area.
If all the above questions have been answered “No” authorization to enter the factory can be granted by any member of the Hunter Foods L.L.C
If any of the above questions have been answered “Yes”, authorization to enter the factory can only be granted after further
consultation by a member of the Hunter Foods, Quality Department.
To be filled by Hunter Foods only,
Name:
Department: Approved Signature:
Position: Denied
Title: Visitors Entry Questionnaire Page 1 of 1
Doc Reference: HFL-QA-CHK – 01.01 Revision No: 02 Date: 01.03.2023