Safety Questionnaire - Infectious Diseases

To complete this questionnaire, you must first read & acknowledge the ‘Labourplus

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Infectious Diseases Awareness’ document located in your Employment Hero account.
To locate the document, go to your ‘Files’ tab followed by the ‘Policies’ tab. Click on the
document, read it and then tick the acknowledgement box.

Please enter your details in the fields as required and answer questions 1 to 10 by choosing one answer at each
question. If you are using this form electronically, in order to save your answers you must first save the completed
document to your computer and then upload it to your Employment Hero account. If you do not save the completed
document to your computer first, your changes will not be saved. To upload the completed document to your
Employment Hero account, go to your ‘Profile’ tab and then your ‘Certifications’ tab. Upload the completed
document to the option titled ‘Safety Questionnaire – Infectious Diseases’. If you require assistance, please contact
Labourplus on 1800 729 566 or mobile 0429 836 663. Alternatively submit your completed document by emailing:
info@labourplus.com.au and we will upload it to your Employment Hero account for you.

YOUR DETAILS
Muhammad Abu Bakr
First Name: Last Name:
mabubakr14@gmail.com 0416620351
Email: Phone No.:
NPB 19 03 2019
Host Client: Date: / /

QUESTIONNAIRE
1. What is the most simple and effective way to 6. Should any sharp or needle be picked up without
prevent the spread of disease? (tick one) appropriate PPE (tick one)
Vaccinations Yes
Washing your hands No
Not leaving the house Sometimes
2. Name a common way diseases spread. (tick one) 7. What should you do if you believe you have been
in contact with bodily fluids? (tick one)
Over the phone
Report and seek medical attention immediately
Contact with bodily fluids
Go to work as usual
Through water
3. Which one of these is considered infectious Don’t tell anyone
diseases applicable to your workplace? (tick one) 8. What do the letters P P E stand for? (tick one)
Hepatitis B Personal Protective Equipment
Ebola People Playing Everywhere
Black plague Personal Proactive Equipment
4. Which one of the following is considered a 9. Why do we need vaccinations? (tick one)
contact precaution? (tick one)
Prevent against diseases
Wearing gloves
Help spread disease
Using surface spray
Give you more energy
Walking away from a blood spill 10. When should you wear gloves (tick one)
5. When should you wear gloves? (tick one)
Dealing with any bodily fluid or people
When I feel like it
When you want to look special
If I may come in contact with bodily fluids
When it’s cold
I don’t have to wear gloves

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IMPORTANT: This form is a fillable form. Once you have completed the document, you must SAVE
the document to your computer first before submitting the form. If you do not SAVE the document
first, you will lose all of your changes. Please check all changes have saved before submitting form.

Labourplus - Safety Questionnaire - Infectious Diseases 1