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Pre-Treatment Guidelines & Assessment during lockdown periods

Please ensure that you read and complete the treatment form. If you have any concerns then please speak to the therapist or consult a medical professional for more information.

Are you an existing customer?

Reasons for visit during Covid-19 national lockdown.

Covid-19 national lockdown guidelines state that personal care facilities are to close and the exemptions permitted include: dental services, opticians, audiology services, chiropractors, osteopaths, and other medical or health services including services relation to mental health. For more information see www.legislation.gov.uk

I have read and understand the Covid-19 restrictions. Due to the impact on my life, my reason(s) for treatment is (please choose relevant boxes) .

Please rate on the scale below the impact the issue is having on your life and everyday activities. Where 1 is Low impact and 5 is high impact. 

Please select from 1-51. Little or no impact2. Some impact3. Medium impact4. High impact5. Very highPlease select from 1-5
Are you considered to be at extra risk due to Covid-19?
If yes, do you require or have permission from a medical professional?
Treatment required
I confirm that I have not come into contact with anyone with Covid-19, experienced any symptoms or been asked to self-isolate.
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