Covid-19 information and guidance

You are required to complete and return this form 24 hours before your face to face appointment.

I will not be able to see you face to face, if I do not receive it, prior to your appointment.

The following details are for your information, to keep you full informed of the steps that I am taking to ensure our mutual safety.

  • Please arrive on time for your appointment.
  • I will ask you to leave any unnecessary items, such as bags in your car.
  • You will be required to wear a face mask on entering the building and until you reach the therapy room (I will provide one if you do not have your own.)
  • I will ask you to hand sanitise on arrival. Please avoid touching handrails and surfaces.
  • I will ask you to adhere to current social distancing guidelines.
  • I am allowing half an hour between clients to fully clean the clinic area and allow full ventilation of the room, so I will keep appointments strictly to time in order to ensure that I have sufficient time to prepare for my next client. (If you are late for your appointment, your appointment will only be available for the allotted time. I will not overrun)
  • Hand sanitiser will be available throughout your appointment. I will ask you to hand sanitise before you move on to the clinic bed.
  • I will be using disposable covers for the clinic bed. All used covers will be removed, and the area sanitised between appointments.
  • Payment is in advance of sessions via payment link or PayPal.

Please reply to the following:

    I understand that I am attending the appointment at my own risk and confirm I will follow government guidance in relation to Covid19:

    I confirm that I have not experienced any COVID-19 symptoms in the past 7 days. (These include a persistent cough, a sore throat, a high temperature, flu-like symptoms, loss of taste of smell):

    I confirm that no one in my household has experienced any COVID-19 symptoms in the past 14 days:

    I confirm that I have not been asked to self-isolate as part of the NHS Wales Test, Trace and Protect system or UK Government Test and Trace program within the last 14 days:

    I acknowledge that in spending more than 15 minutes at Spark Hypnotherapy, in a face-to-face session, that I will be deemed as a ‘contact’ in respect of the NHS Wales Test, Trace and Protect system and agree to be contacted as such:

    Your name:

    Your email:

    Date:

    Your telephone:

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