Client Covid-19 Disclaimer

Following the COVID-19 pandemic, we have put extra measures in place for the safety of you and other colleagues within the building. All clients are required to fill in our COVID-19 form before arrival so that we can provide the best possible and safe experience to clients and staff members.

Please carefully read and answer the questions below. This information will be stored confidentially and securely for 21 days. If you or a member of your household has developed a cough, fever, breathlessness, sore throat or headaches in the last 14 days, please contact your therapist or personal trainer directly before your appointment so we can obtain further information from you and give you the correct advice.

Please get in touch if you have any questions.

We look forward to welcoming you back.

Name

Tel

Have you experienced any of the following symptoms in the last 14 days? Fever, dry cough, sore throat, shortness of breath, loss of taste/smell.

Yes No

Have you travelled overseas in the last 14 days?

Yes No

Have you had any contact with anyone (within 2 metres) that has suspected Or confirmed COVID-19 in the last 14 days?

Yes No

I knowingly and willingly consent to the services at CPF during the COVID-19 pandemic. I consent for the services to be carried out and being in physical contact with the therapist or personal trainer with less than 2 metres distance. I waive any and all liability for the unintentional exposure or harm due to COVID-19.

Please tick the box.

I have understood, read and completed this form truthfully to the best of my knowledge.

Please tick the box.

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