Covid 19 Track and Trace form and other useful information before your appointment

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If you DO NOT have the app to scan on arrival at our therapy room/shop
please fill out this form before your visit

Sanitising gel is available to use as is the QR code to scan before entering the therapy room
please bring with you a face mask
bottle of water with a snack if you are having a therapy

The space is cleaned after each appointment

Have you or someone you live with tested positive/have symptoms of covid 19 within the last 10 days? *

Yes

Have you been in contact with anyone that has covid-19 or is showing symptoms in the last 24 hours? *

Yes

Have you recently traveled oversees ? *

Yes

Are you attending a therapy or shop appointment? *

Shop

Therapy

Name *

Email *

Phone number *

Time & Date of your appointment / other information you feel I should know .. eg exemptions, *

Submit

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