New Customer Registration Form

DATA CONSENT FORM

I, the undersigned, give permission for personal and medical data to be collected and used for the purpuses of maintaning an electronic patient record.

I understand that the data will be shared only with person who are directly involved with my care and that this may include doctors and health profesionals outwith the Foot Health Practice.

I agree that data may be used to contact me via email or text to remind me of appoitments, check ups or payments that are due. Otherwise the data will not to be shared or used for marketing purpuses or any purpuse that does not involve my current foot care.
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TREATMENT CONSENT

I confirm that I am aware that during the treatment sharp medical instruments can be use. I agree that medical history is up to date.

I give my written consent to Foot Health Practice to carry out my treatments.
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CANCELATION POLICY.

48-hours notice must be given to change or cancel an appointment. Less than 48 hours for cancelation, re-arrangement of an appointment or failing to attend an appointment- FULL CHARGE for the planned appointment will become due. Unpaid invoices for missed/late cancelations may be sought through money claims. By booking an appointment at our clinic, you agree to these terms and conditions.
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