Covid-19 Health/ Safety Information and Treatment consent form
Covid-19 Health/ Safety Information and Treatment consent form

Covid-19 Health & Safety Information

Coronavirus is a novel virus that is highly contagious and can be transmitted through contact with contaminated surfaces and through respiratory droplets in the air from an infected person.

Currently, there is no vaccine available and we, therefore, have to implement measures throughout the clinic to minimise the risk of transmission or exposure to the virus. This is following advice from the Chartered Society of Physiotherapy CSP, Public Health England, Health & Safety Executives and the Government.

The guidance below will highlight what is expected of you before and during your attendance at the clinic.

Please read through and confirm you have read and understood the policy by submitting the form at the end

Treatment Process:

Your care will commence with an initial remote Covid-19 screening questions to limit the face to face contact and for the clinician to consider the risk to you (the patient), others in the clinical setting or to the patients household. A balanced and reasoned decision will be made together on how to proceed. Either with the face to face contact or virtual. The benefits of seeing the patient face to face must outweigh the risk of infection transmission.

All patients will be triaged for symptoms of Covid-19 prior to any face to face consultation. This screening will consist of a series of questions set out below:

  1. Do you have a new continuous cough?
  2. Do you have a temperature?
  3. Are you experiencing a reduction in your sense of smell or your sense of taste or both?
  4. Have you or any member of your family had a positive Covid-19 test?
  5. Are you or any members of your household experiencing any of the above symptoms?

You must inform us if you or any member of your household have any of the above.

If any of the above answers indicate the potential presence of Covid-19, then the face to face contact unfortunately will not be undertaken and you will be advised to seek testing self isolation and to follow the government guidance.
If any member of your household is experiencing symptoms then the face to face will not be undertaken and they will be advised to seek testing, self isolation and to follow the government guidance.

You must also inform us if you have been asked to be shielded by your GP or the government.
Please notify us if you have returned from abroad in the last two weeks.

Face to face treatment:

If the clinician determines it is necessary to see you face to face:

  • The risks of contact will be discussed with you with measures that will be taken to mitigate the risks and your consent will be recorded in the clinical notes.
  • Discussions will highlight that the interaction will include contact between yourself and the physiotherapist of less than 2 meters.
  • The Physiotherapist will wear the following PPE, disposable gloves, disposable plastic apron, surgical masks and goggles or visor
  • Assessments and treatments may include manual therapy techniques of mobilisations, manipulations and soft tissue release techniques. Electrotherapy modalities for treatment and muscle testing may also be used along with exercise therapy. Naturally, during the consultation we will try to ensure social distancing, but where not possible your position will minimise the risk by using the lying face down position.
  • All surface will be wiped down with appropriate anti-viral product in between patients
  • You will be asked to arrive no earlier than 5min before your appointment.
  • You can wait in your car to be collected by your physiotherapist or your physiotherapist can drop you a text when she’s ready for your consultation
  • Please come alone (unless carer/guardian in appropriate circumstances)
  • Unfortunately, Toilets will not be available to minimise the risks

On arrival to the clinic:

The Covid-19 screening questions will be asked again in case of any change in symptoms since the virtual contact

  • You will be asked to use the provided hand sanitiser at the clinic entrance
  • Put on the mask if not currently wearing one on arrival
  • All the PPE will be made available for you at the clinic
  • If no symptoms, a non-contact thermometer check will be completed

If your temperature reads above 37.5 deg C, then the appointment will be declined due to this being a potential early symptom of Covid-19. You will be advised to contact 111/online advice and education and the appointment will be rescheduled.

The treatment room:

  • The sitting arrangements will be 2 meters apart
  • During the consultation, we will try to ensure social distancing where possible
  • Where not possible your positioning will minimise the risk for example using position where you are lying face down as appropriate to your treatment
  • The treatment room will be ventilated
  • Contactless payments will be used, either by card or bank transfer. NO cash will be taken

Exiting the clinic:

  • Your mask will be kept on until you leave the clinic
  • All used PPE and coach roll will be put in a double bag for 72 hours and then disposed off in household waste as per regulations

Please tick the box and submit your details to confirm that you have read and understood the above policy:

    Yes I understand the Covid-19 Health & Safety Policy

    *Required fields

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