Workplace Surveillance Installation Consent Form

This form is to inform you and obtain your written consent regarding the installation and use of surveillance systems within the workplace premises.

Employee Information

Full Name Position/Title Department

Surveillance System Details

Areas Covered Purpose of Surveillance Type of Surveillance (e.g., CCTV, audio, etc.) Installation Date

Consent

I acknowledge that I have been informed of the installation and presence of surveillance equipment in the specified areas of the workplace. I understand the purpose and scope of such surveillance and consent to its use as outlined above.

Employee Signature Date

Employer/Manager Signature Date