Covid-19 Declaration

Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

Email

My body temperature is lower than 37.5°C

I am not experiencing any of the symptoms eg: fever, cough, runny nose, sore throat

I haven’t been in close contact with a Covid-19 patient in the last 14 days

I have not visited a Covid hotspot in the last 14 days

Initials

Date

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

Thanks for submitting!

Monday 9am - 10pm

Tue & Wed 7pm - 10pm

Thu & Fri 8am - 10pm

Saturday: 9am - 6pm

Sunday: closed

All sessions by appointment only