COVID-19 Client Declaration Form
To help prevent the spread of COVID-19 in the clinic and local community, we ask each patient/client to complete and sign this 24 hours before attending for treatment. On review of the form, I may contact you to ask you not to attend the clinic at this time and will discuss a suitable future appointment for your treatment.
N.B. Every question must be answered.
I have taken extra measures to safeguard all my clients prior to arrival. I kindly ask you to complete this declaration for the safety of you, other clients and the therapists attending this clinic.