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Awarded 5 STARS for Clinical Excellence & Academic Research

England Beach Football

Official and Exclusive Physiotherapy / Medical providers to the England Beach Football Team.

We are

KENTON, NORTHWOOD, STANMORE & WIMPOLE ST NOW OPEN

We have recently relocated our clinic in Kenton to a new and improved clinic just down the road.  Our new address is 386-388 Kenton Road, Harrow, HA3 9DP

020 8907 7666

Call us today to book your
appointment or email us at
askaphysio@anatomie.co.uk

LOCATIONS

Harrow - Bushey - Northwood,
Hatch End - Mill Hill - Stanmore
Central London - City of London

OPEN

Monday - Saturday

COVID-19 Pandemic Physiotherapy Treatment Consent Form

I knowingly and willingly consent to have face to face Physiotherapy Treatment completed during the COVID-19 pandemic. I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. It is impossible to determine who has it, and who does not, given the current limits in virus testing. I have been made aware that under the current pandemic, Physiotherapy care is primarily conducted via online Telehealth appointments, but that a face to face consultation may take place when clinically necessary and a risk assessment has been undertaken. I understand that the during my appointment, the Physiotherapist will be wearing Personal Protective Equipment (PPE), as set by Public Health authorities and that I have been advised to wear a face covering whilst within the clinic. I confirm that I have not had any of the following symptoms of COVID-19 listed below within the last 14 days or knowingly been in contact with anyone with these symptoms:
• Fever (Temperature of above 37.9)
• Shortness of Breath
• Loss of Sense of Taste or Smell
• Dry Cough
• Runny Nose
• Sore Throat
I am aware that there is an increased risk of coronavirus infection, if I choose to attend a face to face consultation, despite all precautions being taken.
Please ask your physiotherapist before signing this form if you have any questions about this information.
• I confirm I have read and understand the content of this consent form, including that there is a risk of coronavirus infection in attending a face to face consultation;
• I confirm that I am willing to accept that risk and any consequences thereof;
• I agree to undertake a face to face assessment despite this risk.

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