Notification of
an External Outing

Type of outing*

Social outing

Appointment

Care Community*

Residents Name*

Resident Room Number

Name of person accompanying resident*

Mobile of person accompanying resident*

Email Address*

Where are you going?*

Notes for Team (eg. meals not required, transport or carer requirements)

Date and time of departure from residence*

Date and time of return*

I understand that: The resident or I will advise the Care Manager of any areas of concern that may have arisen between the time of completing this form and the outing. If there is a change to the status of any of the people attending the outing with regards to a person testing positive to COVID-19 or being a close contact, I will notify the residence immediately. I understand all the above points *

Yes

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