COVID-19

PLEASE CANCEL YOUR APPOINTMENT AND DELAY

YOU OR ANYONE ELSE IN YOUR HOUSEHOLD

OR ANYONE THAT YOU MAY HAVE BEEN IN RECENT CONTACT WITH

HAS BEEN UNWELL OR DISPLAYING ANY SYMPTOMS SIMILAR TO A COLD - NO MATTER HOW MILD OR SEEMINGLY INSIGNIFICANT IT MAY APPEAR.

Even though some guidelines have been relaxed, please wear a suitable face mask covering to your appointment.

Signs & Symptoms to watch for

Raised Temperature (fever) and/ any symptoms no matter how mild, similar to the common cold, new cough, sore throat, wheeze or sneezes, headaches, loss or change to taste and/or smell, occasionally cases of vomiting and diarrhoea have also been reported.

Some services and treatments that involve work on or close to the highest risk zone - close to or on the face - may be restricted due to Covid risk of infection

eg. Facial Treatments, Facial Reflexology, Massage on face or head. Please ask if the treatment you require is currently possible.

The Therapist will be wearing a Face Mask throughout your treatment.

Breath Coaching® sessions can also take place via on-line video calls - WhatsApp or FaceTime calls. In-person appointments are also possible but recommended in an outdoor location or in an area with suitable sufficient ventilation.

Clients who are visiting for a Therapy treatment appointment, should attend on their own unless the treatment is for a Child under 16, the parent/Guardian must remain

present throughout.

Parents/Guardian who accompany children, in particular for Ballet Shoe

or Pointe Shoe Fittings are requested not to bring other persons to the

appointment if at all possible without prior arrangement and are reminded

that they are responsible for guiding and supervising their child and to try to follow social distancing guidelines whenever possible.

When possible, there will be additional ventilation through use of open windows to the Treatment room/Studio space.

Please bring the minimum of personal belongings with you.

eg. Mobile phones, purse and any jewellery should be kept on your person or safely stored in your bag.

You will need to complete any Medical History Health Questionnaire forms that are required for Therapy treatments or Exercise participation, ideally prior to your visit to save time.

Currently, with the relaxation in Government guidelines regarding Covid, there is no need to complete the Covid-19 health screening form prior to your visit until further notice, but I respectfully reserve the right to refuse treatment OR turn away anyone that arrives to an appointment, showing any signs or symptoms of illness. FACE MASKS MUST BE WORN PLEASE.

PLEASE WEAR A
FACE MASK

If you don't have a face mask you will be provided with one.

temperature MAY be taken BEFORE YOU ENTER

You will be turned away if your temperature is raised.

rub your hands well with
alcohol HAND SANITIZER before entry

COVID-19 Health Declaration

Please read and answer carefully. A form is required for each person. Please submit your form on the day, prior to your visit / appointment.

You may be turned away on arrival if displaying any symptoms. Face Masks must be worn.

First Name

Last Name

My body temperature is lower than 37.2C

I am not experiencing any other symptoms - sore throat, cough, sneeze, wheeze, headaches, mild flu like symptoms. I have not noticed a loss of, or change in normal sense of taste or smell.

I have not been in contact with anyone with Covid-19 symptoms in the last 14 days or anyone in my household that has any symptoms

There is no history of any foreign travel within the past 14 days

Initials

Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

Inc. Pointe Performance

COVID-19

PLEASE WEAR A FACE MASK

temperature MAY be taken BEFORE YOU ENTER

rub your hands well with alcohol HAND SANITIZER before entry

COVID-19 Health Declaration

PLEASE WEAR A
FACE MASK

rub your hands well with
alcohol HAND SANITIZER before entry