Pre-Appointment COVID-19 Screening & Triage Form
 
Your proposed accompanier must first call clinic to answer COVID and risk questions
 
Triage
 
If the condition is not painful, you CANNOT attend for treatment.
 
COVID-19 Screening
 
 
Do you have any of the following symptoms:
 
 
If you answer YES to ANY these questions, you CANNOT come for treatment or accompany a person coming for treatment.

General Health
 
 
If you, answer YES to this question, you CANNOT come for treatment
People at High Risk

 
If the answer is YES, then answer following questions If NO, then go to moderate risk.
People at Moderate Risk
 
 
Please note that if you have received a letter from the NHS advising you are HIGH RISK, or you have answered YES to ANY of the above moderate risk questions, you cannot be booked for treatment without first having your case reviewed by a physiotherapist.

Please submit your form and we will get back to you