Check-in for your apppointment

I know this is a difficult topic with regards to vaccines, so I apologise is this is uncomfortable in in any way.

If you are not vaccinated, I'm so sorry I cannot see you for your appointment as my husband is 'vulnerable'.

Please could you send me an email to let me know that we cannot go ahead with your appointment. Thank you.

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If you have answered YES to any of the questions in this section, you can stop filling this in.

Please get in touch, as we will need to postpone your appointment. Thank you.

Please remember to change out of work clothing and shower before coming to their appointment, especially NHS frontline staff.

I declare that the information I have provided is true and correct.

If any person should suffer as a result of this information being found to be untrue and false, then I am aware I can be prosecuted for making a false declaration.

Should anyone I have been in direct contact with over the past 14 days tests positive for Covid-19 I will take advice from NHS, my GP, 111 and 119 as to whether it is necessary to inform Leora.

I understand  that I cannot attend my appointment if I (or any of my close contacts) have ANY cold or flu-like symptoms, (even if it is confirmed not to be covid) or if I attend with symptoms, I will be refused entry to the clinic.

I understand that even though we are taking all necessary precautions, your visit and massage is not 100% risk-free from COVID-19?

IF YOU SEE A MESSAGE BELOW ASKING YOU TO CLICK TO ACCEPT COOKIES, PLEASE BE SURE TO DO THAT BEFORE YOU CLICK SUBMIT.