Covid Pre-Treatment Questionnaire

Please complete and return this form no more than 24 hours prior to your treatment and
contact Sharon Ward if you have any questions. Thank you.

Please defer your treatment if you: are waiting for a COVID-19 test result; have recently tested positive for COVID-19; or have a high temperature, new continuous cough, or a loss or change to your sense of smell or taste. If you currently have symptoms of COVID-19 but have not yet used the NHS 111 online coronavirus service, please do so. If you have any other new or unusual symptoms, please discuss these with your therapist before your appointment.
If you have had COVID-19, please seek consent from your GP or consultant before treatment
If yes to either question, please defer seeing your therapist until it is safe to do so.
If you are classed as clinically extremely vulnerable and require shielding, you will have received a letter from the NHS explaining this. Defer treatments until the government indicates that it is safe for you to leave home or have visitors providing non-essential care.
Unlike people at high risk, those who are classed as clinically vulnerable will not have received a letter from the NHS. If you are unsure if you are clinically vulnerable, please refer to the NHS website at If you meet the definition of someone who is clinically vulnerable, please discuss this further with your therapist and seek consent from your GP, midwife or consultant before having a treatment.

Please check your temperature on the morning of your treatment. If it is higher than usual, or if you have any other symptoms, please contact your therapist to defer your treatment. Please ensure that you follow all new procedures explained to you by your therapist, prior to treatment.

Your therapist has carried out a full risk assessment and adheres to COVID-19 guidelines produced by the government and their professional association, the Federation of Holistic Therapists (FHT). For more information, visit