COVID DECLARATION

Chiropractors and other medical services were specifically exempt from The Health Protections Regulations (Coronavirus Restrictions) that came into effect on 26^th March 2020.

Before you visit please complete this form. Your chiropractor will prioritise your health and have the final say as to whether they accept you for treatment.

Main symptoms

The main symptoms of coronavirus are:

• high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
• new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
• loss or change to your sense of smell or taste – this means you’ve noticed you cannot smell or taste anything, or things smell or taste different to normal

Most people with coronavirus have at least one of these symptoms.

Check if you or your child has coronavirus (COVID-19) symptoms – Click Here

If you or anyone you live with has symptoms:

• High temperature – your chest or back feel hot (you don’t need to measure your temperature)
• New, continuous cough – coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)

Then do not come in and make sure you’re Self Isolating according to Government Guidance.

Government covid-19 stay at home guidance

Government guidance on social distancing for everyone

Consider the risk to you and others:

In some cases of Coronavirus (Covid-19) the symptoms and complications are severe or even fatal. The safest place during this pandemic is at home. Every time you leave your home you increase the risk of catching or transmitting Covid-19. Please reflect on this before coming.

People at higher risk should have had a letter from the NHS asking them to “shield” for 12 weeks, for example you’ve had an organ transplant or are on chemotherapy. If this is you then you must speak to your chiropractor before coming in.

There’s also a larger group of people who are at moderate risk from coronavirus. These are people who:

• Aged over 70
• Are seriously overweight with a BMI of 40 or above (check at home if unsure)
• Have a long-term lung condition (such as COPD, bronchitis or emphysema)
• Have chronic heart, kidney or liver disease
• Have diabetes
• Have chronic neurological conditions (e.g. Parkinson’s disease, motor neurone disease or MS)
• Have problems with your spleen (e.g. sickle cell)
• Have a weak immune system (e.g. HIV, AIDS, steroids, immunosuppressants or chemotherapy)
• Are pregnant

NHS advice for people at high-risk

In Summary:

• DO NOT COME IF YOU SHOULD BE SELF ISOLATING DUE TO CORONAVIRUS SYMPTOMS
• Speak to your chiropractor before coming if you should be “shielding” for 12 weeks as per Government guidance
• Consider your personal risk factors before coming (e.g. aged 70 plus)

When coming to the clinic please:

• DON’T arrive early
• DON’T bring unnecessary people with you into the clinic
• Bring a freshly laundered TOWEL with you (we’ll use it to reduce contact during treatment)
• Please wear a FACE MASK for the duration of the time in CCC
• Thoroughly use the SANITIZER to wash your hands when you arrive
• Sit 2 metres apart in reception and keep 2 metres from the receptionists
• Review relevant posters in the clinic
• Note that we may leave some doors open to keep the air circulating and reduce touchpoints
• Avoid touching things unnecessarily when you are in the clinic

Covid-19 consent:

By signing below, I confirm that:

• I understand and agree to follow all the statements on this form
• I have considered the risk of transmission of Coronavirus as a result of attending the clinic and would like to attend
• I understand Coastal chiropractic Clinic cannot accept responsibility for transmission of the Covid-19 should I become infected