COVID-19 Questionnaire / Self Declaration

In the interests of the health & safety for the people of this property, their families and the community, we ask that you complete the following questionnaire / self-declaration.

Your co-operation and support are appreciated.

Please check you have entered all details correctly:

Personel Details

Question 1

Have you been in close contact with anyone who has been diagnosed with the COVID-19 virus?

Question 2

Do you live in the same household as someone who has symptoms of COVID-19 or who has been in isolation within the last 14 days?

Question 3

Do you have any of the following typical COVID-19 symptoms:
  • Fever;
  • High temperature;
  • Persistent coughing or;
  • Breathing difficulties / shortness of breath.

Question 4

Are you defined in public health guidance as extremely vulnerable and at very high risk of severe illness from COVID-19 because of an underlying health condition?

Question 5

Have you or a member of your household been advised by a notification that, in accordance with that guidance, they need to follow rigorously shielding measures?


In submitting this questionnaire, you confirm that the information provided is true to the best of your knowledge and current condition. You commit to advising Rodgers & Finney if your situation or condition changes before your viewing appointment.