Consent Form COVID-19
It is essential that you complete this form prior to EACH face-to-face appointment. You must answer all questions.
YOU MUST NOT ATTEND THE CLINIC IF:
- You have any Covid-type symptoms (even if you have tested negative)
- You are self-isolating due to being a close contact of a confirmed case
Following the form is some important information about your appointment which we ask you to please read.
Further information about your appointment:
Covid-19 and Face-to-Face appointments
Following your initial appointment or virtual triage, if your physiotherapist’s professional opinion is that the benefit of a face-to-face appointment outweighs the risks involved in coming into the clinic instead of continuing your care by virtual means, an appointment will be arranged for you.
We will undertake all means possible to reduce the risk of transmitting conronavirus to you, us, and other patients. We need your co-operation to do this.
Prior to your arrival at the clinic, you must complete the above form as accurately as possible.
On arrival you will:
- Have your temperature checked
- Be asked to wear a mask or face covering – if you do not have your own, we will provide one for you
- Be asked to sanitise your hands
- Avoid touching surfaces
- Avoid bringing extra bags or clothing
Your physiotherapist will be wearing PPE including a face mask, gloves and apron; and may also wear a face shield depending on the treatment involved.
Please arrive on time for your appointment, but no earlier than 5 minutes before your scheduled appointment time. Appointments will be scheduled to reduce the overlap of people in the clinic and to allow for additional time to clean the room between appointments. If you are late for your appointment, we may not be able to make up your time.
If you need to be accompanied at your appointment, we will also need to triage the person accompanying you, and they will need to fill in the above form as well.
Payment will be required either by card or BACS payment. In most cases we will ask for your card details to be provided in advance so as to minimise the time you need to be present in the clinic after your appointment. Those people who are covered by their private medical insurance will also be required to provide card details in advance.
Thank you for your co-operation.