• Midrand Chiropractic lockdown informed consent (follow up treatments)

    Dr Kendrah L Da SIlva
  • Consulting your chiropractor during lockdown

    We find ourselves in an unprecedented situation where your health and wellbeing are a primary focus. The chiropractic profession has been given permission to cautiously consult patients from level 4 lockdown.  What does this mean for you?

    Very stringent hygiene protocols have been implemented - more than before.  The purpose of these protocols is to reduce the spread of COVID - 19, and decrease the possibility of contamination.  Thus, the following will apply when you want to consult with me:

    a) A consent form particular to this lockdown period, will need to be signed for each treatment.  This you will need to print out or digitally sign and return to me. Without this consent, I will be unable to receive you in the practice.

    b) Please come alone if possible.  Persons accompanying you will be requested to remain in the car outside.  

    c) You are requested to remove all jewellery, watches etc. and to leave bags and phones in your vehicle.

    d) You are requested to bring your own change of clothes (prefereably arrive in your change of clothes) which are loose fitting.  Please bring your own towel if possible. As winter approaches, please bring a blanket with if you think you may get cold.

    e) You will be required to sanitise your hands on entering the practice.

    f) You will have your temperature taken, and a set of questions regarding COVID - 19, at each appointment.

    Should you be comfortable with the above, please complete the Lockdown Informed Consent form, and return it to me, prior to your appointment.

  • Lockdown Informed Consent

    To be completed for each and every treatment during the lockdown period
  • PRACTICAL GUIDELINES TO THE CONSULTATION:

     

    1.1           I, have read and understand the practical guidelines as set out hereunder and confirm that I will comply thereto and prepare accordingly.
     

    1.1.1           I will sign all consent forms at home with my own pen and bring the forms to the practitioner’s practice, failing which I will not be treated. I may also sign same electronically and email same to the practitioner.
    1.1.2           Patients will be phoned and screened the day before consultations, and requested to take appropriate action if they are presenting with any risk symptoms or history.
    1.1.3           Patients will be stopped from entering the practice if the patient hasn't complied with proper control measures.
    1.1.4           Patients will not be allowed in the waiting room and will be requested to wait in their cars until called by the practitioner or a staff member to enter the practice.
    1.1.5           All patients will be sprayed with hand sanitiser upon entry.
    1.1.6           All patients must wear a face mask alternatively a face mask will be provided to the patient.
    1.1.7           On arrival, patients will again be screened for risk factors including the taking of a temperature.
    1.1.8           Between consultations, the necessary hygiene/cleaning protocols will be done by the practitioner and/or their staff compliment and this may cause a delay and prolong waiting periods.
    1.1.9           Patients are requested to avoid touching anything inside the practice.
    1.1.10        Patients are requested to remove any jewellery and leave same at home as it can be carriers of infections droplets.

  • Please check each box as is appropriate.

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