Pilates 1-1

Name: Pilates 1-1
SKU: 12540
Price: 40.00 GBP
Availability: InStock

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Your Health - Covid-19*

Do you have underlying health conditions or are you in receipt of a letter from the Government to say you are in a high-risk category?

Yes
No

If yes, please specify:*

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Have you had, in the last 14 days any of the following
Please answer all of the following questions

A High Temperature*

This means you feel hot to touch on your chest or back (you do not need to measure your temperature)

A 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)

A 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

Have you travelled significantly or travelled abroad in the last 14 days?*

Yes
No

If yes, please specify:*

The clinic has undergone a risk assessment of the environment and we have mitigated potential infection risks. We have introduced infection prevention and control measures including the wearing of personal protection equipment (PPE). As part of these changes we have no waiting room facility and ask you to wait in the car park until your practitioner comes out to call you in once they have cleaned after the previous patient. You will be required to wash your hands with soap and water before entering the treatment room. We are asking patients to wear a mask covering their mouth and nose for treatment. Please contact us by telephone beforehand if you are unable to meet with this requirement.

Do you give us consent for a hands-on face-to-face treatment?*

Yes
No

Consent*

Prepayment is required for your booking to be confirmed - please follow the steps to pay online. When an appointment is made, a minimum of 24hours is required for cancellation & refund.

I confirm that my answers to the Covid-19 Triage Questionnaire are accurate and that should there be any changes before my appointment I will contact Martinvale Clinic to advise them of the changes.

Name

This field is for validation purposes and should be left unchanged.

Covid Triage Form

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