Covid 19 Consent and Waiver

Covid 19 Consent and Waiver

To comply with the needs of my insurers, all clients attending in-person appointments must please sign this Waiver.
Under The Health Protection (Coronavirus, Restrictions) (England) (No. 4) Regulations 2020, my practice is permitted to stay open for in-person appointments and clients are permitted to leave their homes to attend appointments. My premises are Covid Safe.
Risks of Opting for In-Person Services: I understand that by coming to the office, I am assuming the risk of exposure to the coronavirus (or other public health risk). This risk may increase if I travel by public transport or cab.*

Agreed
I understand that if I show up for an appointment with a fever or other symptoms, or I believe I may have been exposed to Covid 19, my appointment may be cancelled and no refund given.*

Agreed
I understand that my therapist takes health matters seriously for everyone concerned and will inform me if he believes he has symptoms. In such cases the session will take place over Zoom if he is well enough.*

Agreed
I confirm that I have not had any of the following symptoms in the last 14 days: fever, dry, persistent cough or a loss of sense of taste or smell.*

Agreed
I confirm that I am not in the clinically extremely vulnerable category and have not been advised to shield at home by the government or my doctor.*

Agreed
I confirm I am aware of the requirement for social distancing in the practice.*

Agreed
I confirm I am aware of the requirement for hand sanitation in the practice:*

Agreed
I understand that this release discharges my therapist, Matt Davies, from any liability or claim that I, my heirs, or any personal representatives may have against Matt Davies with respect to any bodily injury, illness, death, medical treatment, or property damage.*

Agreed
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