MEDITE Site Access Form

Due to the ongoing challenges posed by Covid-19 virus we are asking all people who visit MEDITE Europe DAC to complete this form before permission is granted to visit site. MEDITE is committed to the protection of its employees, contractors and visitors to our facility. The collected information will solely be used for the purpose of ensuring the continued Health and safety of our employees as part of a national effort to restrict movement and maintain distancing. Individual forms need to be filled out for each individual visiting. Authorisation is valid for 1 visit up to a maximum of 3 days. Thank you for your understanding.

All site visits access are defined as those entries by all non-MEDITE SMARTPLY employed personnel or those who are entering site for the purpose of collection or delivery where existing from vehicle and/or interaction with site personnel or site infrastructure.
Site Access form do not eliminate the requirement or necessity of other documentation required to enter site and perform works such as RAMS (risk assessments Methods Statements). Access may be denied to those who have not provided correct documentation should they be required to do so.
Company contact should be defined as the person under the companies employ who has organised the visit and that the visitor/contractor has been in direct communication with.

Ihre Kontaktdaten

Vorname

Nachname

E-Mail

MEDITE/SMARTPLY Contact Name

The contact name is that of the individual who gave authorisation for site visit.

Name des Unternehmens

Visit Date

On what day do you intend to visit the plant?

Have you been in contact with any confirmed Covid 19 cases within the last 14 days?

Yes

If yes, please outline when

Have you been in contact with any suspected Covid 19 cases within the last 14 days, including people in self isolation?

Yes

If yes, please outline when

Have you suffered within the last 14 days, or are currently suffering from any of the following symptoms?

Fever, Cough, trouble breathing or shortness of breath

Yes

If you are travelling to Ireland from another country, please note the following requirments:

The EU Digital COVID Certificate (DCC) is accepted for entry for travel originating within the EU / EEA.
If you have valid proof of vaccination (such as a valid DCC) or that you have recovered from COVID-19 in the past 180 days, no travel-related testing is necessary.
If you do not have valid proof of vaccination or recovery, you will need to present evidence of a negative RT-PCR result from a test taken within 72 hours prior to arrival into the country. No further travel-related testing is necessary.
A completed electronic Passenger Locator Form.

The latest advice on entry to Ireland can be accessed through the following links:

https://www.gov.ie/en/publication/77952-government-advice-on-international-travel/#travelling-to-ireland

https://www.dublinairport.com/covid-19/covid-19-travel-advice

Terms & Conditions

I consent to MEDITE SMARTPLY collecting and storing my data from this form.

I declare that all information in the above is my own and accurate and not on behalf of anyone else.