Important COVID-19 Notice for all Face-to-face clients
My priority at this time is to keep both my clients and me as safe as possible. In order to achieve this, I have taken measures in line with the Coronavirus act of 25th March 2020. Please find below details of our working practices during these unprecedented times.
If you have had a fever, dry cough, sore throat, runny nose, difficulty breathing or loss of sense of taste or smell or have been tested positive for COVID-19 in the last 14 days, please DO NOT come to the clinic.
Please also DO NOT come to the clinic if in the last 14 days you have come into close contact with someone who has tested positive for COVID-19.
At the entrance we will scan your forehead to check for a fever. If you have a fever, we will ask you to return home and contact NHS 111.
Booked Appointments Only
DO NOT come to the clinic without booking an appointment. Please book an appointment at www.hampshirecoaching.co.uk/initial_consultation or email email@example.com. Appointments will be staggered to avoid patient crossover with one patient at any time.
Please do not bring anyone with you to the clinic. It is best that they wait in the car.
Please complete, sign and return the COVID-19 disclaimer and additional forms before arriving at the clinic. You will need to complete these forms BEFORE you can enter the clinic.
Please bring only essential personal items with you.
Hand Decontamination & Face Mask
Please wear a face covering. Please disinfect your hands upon entering and leaving the building.
Please maintain the 2-metre social distance wherever possible.
Staff will wear face masks and additional PPE – aprons and gloves as necessary during consultations.
Extensive Cleaning Protocols
Prior to opening the Clinic has gone through a deep clean to ensure a clean environment. Additional cleaning measures are in place to ensure that door handles, surfaces, and touch points are sanitised.
Payment is requested before the consultation, via our online payment system or by card at the time of your appointment to avoid unnecessary touch points.
Any online consultations will be carried out remotely via a secure video link. Please complete paperwork online before your online appointment.
Our opening hours are subject to change in line with operational requirements.
COVID-19 CLIENT QUESTIONNAIRE /DECLARATION
My priority at this time is to keep both my clients and me as safe as possible. In order to achieve this, I have taken measures in line with the Coronavirus act of 25th March 2020 and am duty bound to ask you the following set of questions.
I assure you that the information you give remains confidential unless legally bound to release it and I thank you for your support.
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.
I confirm that I am not in the clinically extremely vulnerable category and therefore advised to shield at home by the government.
I confirm that to the best of my knowledge, I have not been in close contact with anyone with confirmed COVID-19 in the last 14 days.
I understand that coronavirus may not cause symptoms in some people and is currently causing a pandemic which means healthcare services are required to operate differently
I confirm I have been made aware that consultations are available via a telephone/video triage appointment and that I may be asked to change from in-person appointments at short notice during these uncertain times.
About my Visit:
I confirm I am aware of the clinic’s requirement for social distancing in the clinic.
I confirm I am aware of the clinic’s requirement for hand decontamination in the clinic:
I confirm I am aware if the clinic requires me to wear a face-covering whilst inside the clinic ( Exemptions to wearing face masks may apply. )
I confirm I have been told about the cleaning of the clinic room before/after my attendance:
I confirm I am aware of the clinic’s requirement for contactless payment
I understand that my coach is required to wear PPE as set by Public Health authorities during my appointment and this is not optional for them.
About my Coach:
They have confirmed they 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.
They have confirmed that to the best of their knowledge, they have not been in close contact with anyone with confirmed COVID-19 in the last 14 days.
They have discussed with me reasons why my coaching needs may not be met by a telephone/video consultation.
I have had the opportunity to ask all the questions I wish to, and all of my questions have been answered to my satisfaction. Use space below to record details:
I agree to attend a face to face appointment during the COVID-19 pandemic.
Signed Client ………………………………………………………………………..
OR [delete as applicable]
Signature of person with parental responsibility / person legally entitled to sign on behalf of a person who lacks capacity