COVID-19 Declaration Please read the following carefully and confirm that you are happy to proceed with treatment: Due to the Coronavirus pandemic, we are required to take to take extra precautions when seeing patients face-to-face. It is important to understand that there is a risk of infection, when attending Physiotherapy treatment.Do not attend if you or your family presented with COVID-19 symptoms in the last 7 days: Chronic dry cough, Increased temperature or fever Loss of smell/taste. I confirm that neither I nor anyone in my household have presented with any of the COVID-19 symptoms within the past 7 days. PROTOCOL WHEN ATTENDING APPOINTMENTS: Use the allocated undercover Regus parking (particularly if it is raining) or use the visitors parking provided in front of the main Regus entrance. Parking is free of charge BUT AVOID PARKING PENALTIES by register your vehicle registration at the main reception. Please enter main reception and observe 2 meter social distancing. Aim not to touch reception furniture or use the restrooms. Your physiotherapist will meet you and supply you with hand sanitiser and measure your body temperature. Please wear a mask and cover your NOSE and MOUTH. Do not wear any gloves - you will be asked to remove this on first contact with us. Inform your physiotherapist if you have any allergies to latex or powder, prior to the appointment. Only the patient that is receiving treatment on the day, will be allowed into the clinic. If the patient requires a chaperone, let us know, prior to the appointment. Do not bring any unnecessary belongings including handbags/sunglasses etc. Kindly note that we are not accepting any paper documentation in the clinic at present. The treatment duration is 30-45min. Just before leaving the clinic you will be required use hand sanitiser again. Keep your mask on UNTIL you can wash your hands with soap and water. Try not to touch your face. Methods of payment: ONLY Cards are currently accepted. Consider remote consultations if you think that the problem can be resolved in that manner. Remember we have to work together to make sure that everybody stay safe, so please apply the rules. I confirm that I have read and understand this information. Patient First Name Patient Last Name Patient Date of Birth Telephone Number (Parent number if patient is under 18) Email Address (Parent address if patient is under 18) Time is Up!