Covid screening and consent form

Before your first treatment, please submit this Covid screening and consent form.

Covid-19 Screening Information. Tick the box to answer "Yes" to the question. If you answer "Yes" to any of the questions, please contact us immediately.

 Clinically Vulnerable

If you or anyone you live with falls into the 'clinically vulnerable' or 'clinically extremely vulnerable' categories, and we have not already discussed this, please contact us immediately.

Thank you for submitting!