Covid-19 Client Form

To help reduce unnecessary contact, all consultation and consent forms will now be completed online. To ensure the safety of all parties and to stop the further spread of the Covid-19 virus, please complete the below questions as honestly and accurately as possible prior to your appointment date


Covid-19 Screening


Appointment Guidance

  • If you have answered yes to any of the above questions we will be in contact as you may need to reschedule your appointment with us.
  • Please only attend at your appointment time.
  • Please ensure you are on time - if you are late this may result in your appointment being cancelled.
  • Please attend your appointment unaccompanied.
  • Please limit the personal possessions you bring with you.
  • Please wear a face mask/covering to your appointment.
  • Upon arrival please wait until you are called forward to reception.
  • Upon arrival please use the hand sanitiser provided.
  • Please maintain social distancing where possible.
  • If you experience Covid-19 symptoms after your appointment please contact us immediately.



Tap or click on the signature above to sign


Data Protection and Privacy

We are committed to protecting your privacy. We take special precautions with your sensitive personal data and we will process your data lawfully and as described. We only process the data we need for as long as we need to and we respect all of your rights under GDPR. We will never sell, share or otherwise abuse your data. You can contact us at any time to request your data, change your preferences or request that your data be deleted. GDPR is the European privacy law designed to protect you and give you control of your data.


SUBMIT

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