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Little Comfort Farm
Little Comfort Farm
Cottages
Mill House
Sleeps: 10
Caen Byre
Sleeps: 5
The Granary
Sleeps: 4
Woodlark
Sleeps: 4
Exclusive Use
Sleeps: 23
Cottage Map
The Farm
The Farm & Nature
What’s On
Farm Shop
Therapy Room
The Fishing Lake
Children & Babies
Postpartum Retreat
Dogs
Occasions & Venue Hire
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COVID Guest Health Questionnaire (complete within 24 hours prior to arrival)
COVID Health Questionnaire
For all guests to complete prior to arrival
Name
*
First
Last
Guardian/Carer/Parent Name
If you are completing this form for someone else
First
Last
Date of Form Completion
*
DD slash MM slash YYYY
Email
*
Phone
*
Which cottage are you staying in?
*
Mill House
Caen Byre
Granary
Woodlark
Smithy
Arrival Date at Farm
*
MM slash DD slash YYYY
Have you tested positive for COVID-19?
*
Yes in the last 14 days
Yes in the last 20 days
Yes more than 20 days ago
No
Have you had any close contact with someone diagnosed with COVID-19 within the last 20 days?
*
Yes
No
Within the last 14 days have you suffered from any of the following (please select as appropriate):
*
A high temperature (37.8C or greater, or chest/forehead hot to touch)
A new, continuous cough
A loss or change to your sense of smell or taste
No, none of the above symptoms
Within the last 14 days has any of your support bubble or close contacts suffered from any of the following that you know of (please select as appropriate):
*
A high temperature (37.8C or greater, or chest/forehead hot to touch)
A new, continuous cough
A loss or change to your sense of smell or taste
No, none of the above symptoms
Have you been contacted by the NHS test and trace services and asked to self isolate?
*
Yes
No
Are you self isolating after returning to or entering the UK?
*
Yes
No
Please select the following to confirm you agree:
*
If I have answered yes to any questions I will discuss my answers with Little Comfort Farm before I travel
I have reviewed the Government's latest guidance/legislation on permitted gatherings and social interactions and will abide by them
Should my answers change to any of the above questions before or during my stay, I will let Little Comfort Farm know by emailing stay@littlecomfortfarm.co.uk and marking the email as high priority
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Party Size
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Number of nights
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Arrival date
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