Coronavirus Pre-Appointment Confirmation Form

Coronavirus Pre-Appointment Confirmation

As part of our Coronavirus COVID-19 Mitigation Strategy we are asking all of our Clients to complete the form below to confirm that they are fit and well and are able to attend their Appointment. Please complete all of the details below and submit the form.

If you are unable to confirm all elements of the form it will not be possible for us to offer you the appointment and we will need to reschedule it for you and we would appreciate a call as soon as possible in order that we may assist you.

We would like to thank you for all of your help and assistance in tackling this issue and ensuring that we protect our Clients and our Staff.

Please double check your Email Address.
Please ensure that your Appointment Date and Time are correct.
Please ensure that you have checked the NHS Guidance no COVID-19 Symptoms on their website.

The main symptoms are:
  1. high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
  2. new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
  3. loss or change to your sense of smell or taste – this means you've noticed you cannot smell or taste anything, or things smell or taste different to normal
Please confirm that you have not tested positive for Coronavirus COVID-19 within the last 14 days, you are not awaiting a Coronavirus COVID-19 test result and that you have not been in contact with someone who has tested positive for Coronavirus COID-19 or has exhibited symptoms.
Please confirm that you are fit and healthy and well enough to attend your appointment.