COVID-19 Compliance Form

Dear Customer

As you can appreciate, By Urban takes COVID-19 very seriously. By Urban has a responsibility to all staff, suppliers, clients and to the wider community to play its role to endeavour safe work practices.

Our showroom will be temporarily closed to the public and will be open by appointment only. Masks will need to be worn when staff are in contact with the public for appointments in the showroom.

Due to the above we would appreciate you engage with our safe work and social practices by filling out our internal policy procedure form. This will enable us to ensure the wellbeing of all concerned.

By Urban has adopted internal and on-site policies that all employees and subcontractors are to follow. If you would like a copy, please enquire with your By Urban Representative.

Service Required:

Are you or anyone residing at your current place of occupancy under any form of isolation as a result of a recommendation of a Health professional / Government Restrictions?

In the last 14 days, have you or any persons at your place of occupancy been in physical contact with a person diagnosed or been exposed to COVID-19 virus?

In the last 14 days, have you or any persons at your place of occupancy been in physical contact with a person diagnosed, been exposed or self-isolation due to COVID-19 virus?

Have you or anyone residing at your current place of occupancy crossed over or into international or state borders within in the last 14 days?

In the last 14 days, have you or any persons at your place of occupancy experienced any symptoms consistent with COVID-19 (cough, fever, tiredness or difficulty breathing in severe cases?

I confirm that I consent to provide the information above, which I certify is accurate to the best of my knowledge: