With regard to the Risk of Transmission of Covid-19 Please read this document before treatment
Word version available here
If the treatment is for a child under 16 years, the parent or legal guardian will complete and sign a consent form on the child’s behalf.
I am now taking extra precautions to maintain a healthy and safe environment for giving treatments in line with current advice from the UK Government, the Health & Social Care Public Health Agency Northern Ireland (HSC), and my Local Council and my professional body the Craniosacral Therapy Association (CSTA).
- vetting all requests for treatment
- use of recommended PPE during the session by both client and therapist
- sanitising frequently touched objects, such as treatment tables, door handles, and light switches before and after each client
- regularly washing and sanitizing my hands with soap and water and or hand gel.
How the Virus spreads.
This virus is very contagious. It is thought to spread mainly from person-to-person through people who are in close contact with one another (within about 2m or 6 feet) or through respiratory droplets produced when an infected person coughs or sneezes. It is now thought that people may be most contagious with coronavirus before and during the first week of COVID-19 symptoms.
Whilst I am taking every precaution to limit your risk of exposure to coronavirus, I cannot guarantee that there is no risk to you as a result of attending for treatment.
Symptoms of COVID-19
- a high temperature within the last seven days (feeling hot to touch on your chest and back)
- a new, continuous cough (coughing a lot for more than an hour or 3 or more coughing episodes in 24 hours or a worsening of a pre-existing cough)
- a loss or change to your sense of smell or taste
You must not attend the clinic if you have any of these symptoms or have been in contact with anyone who has within the past 7 days.
NHS Test and Trace
I am required to assist NHS Test and Trace with requests for data (including name,
contact number, dates and times of visit) if needed, up to 21 days after the treatment.
Contact tracing staff will ask for these records only where it is necessary, either because someone who has tested positive for COVID-19 has listed my premises as a place they visited recently, or because my premises have been identified as the location of a potential local outbreak of COVID-19.
If I get the call, I would have to give details of anyone I have been with for more than 15 minutes. As a result, depending on the circumstances and length of time that has elapsed, you might be asked to be tested, to take extra care with social distancing or to self-isolate.
The information given will only be used where necessary to stop the spread of Covid-19.
You may opt-out if you do not want your details shared for the purposes of Test and Trace (by crossing out the relevant section on the consent form when you attend for treatment).
Levels of risk
I believe my practice has a robust risk assessment with enhanced procedures for potential face-to-face contact with most clients who are not at risk if they contract Covid-19. However, for those who are in the ‘at risk’ group (clinically vulnerable) the threshold for making a decision to provide care is set higher.
You are deemed to be ‘at risk’ if you are in one of the following categories
- Aged 70 +
- Non-severe lung condition (asthma, COPD, emphysema or bronchitis)
- Prone to infections
- Heart disease, diabetes, chronic kidney or liver disease
- Neurological conditions
- On medication that suppresses the immune system
- Obese (have a BMI of 40 or more (Source: NHS).
- I have read and understood the supplied Risk Assessment.
- I confirm, to the best of my knowledge I am free of the symptoms of Covid-19 and have not recently been in contact with anyone who has.
- I understand that there is a risk of transmission of the coronavirus leading to Covid-19 (the disease) as a result of attending this practice and/or receiving treatment.
- I agree my details can be shared with the Public Health Agency should they request them within 21days of my appointment.
- I agree, in the event that I develop symptoms of Covid-19 in the following 5 days after attending this practice, to inform the therapist of my changed status. This is to facilitate tracing anyone else who may have been potentially exposed to the coronavirus. I will only undertake to do this in the understanding that the therapist maintains client confidentiality at all times.
- I acknowledge I have discussed, or have been given the opportunity to discuss, with my therapist the contents of this document. I have had the opportunity to ask all the questions I wish to at this time and those questions were answered to my satisfaction.
- I understand that I can choose to change my appointment to another date
without incurring costs.
- I consent to the Craniosacral Therapy treatment offered or recommended to me today by my therapist.
If you have any questions about attending for treatment please contact me on 07817741270