COVID-19

In line with current legislation and to ensure the safety of my clients, myself and others I am required to ask that you provide me with information regarding your current state of health and contact details for the track and trace process in the event that either of us develops symptoms or has contact with anyone else who has symptoms of the virus. I thank you in advance for your co-operation and understanding in this matter.

I also ask that if you have an appointment booked or are enrolled on a workshop/course with me that should you develop any symptoms or have contact with anyone else who has symptoms of the virus please inform me but most important of all - do not attend your appointment/workshop/course

COVID-19 Pre-Screening Form

Please complete the following form prior to attending any appointment/course/workshop. Thank you for your co-operation.

COVID-19 PreScreening Form

Date of Visit::*
Full Name:*
Address Line1::*
Postcode::*
Contact Number::*
Please tell me if you are experiencing any of the following symptoms::
- Fever
- Dry cough or sore throat
- Runny nose
- Unexplained muscle or joint pain
- Headache
- Excessive tiredness
- Shortness of breath
- Loss of smell / taste
- Upset stomach / diarrhoea
- Loss of appetite
Have you or any of your close contacts experienced any of the above symptoms in the last 14 days or been tested positive for COVID-19?:*
Have you or any of your close contacts been near anyone who has tested positive for COVID-19 in the past 14 days?:*
Have you or any of your close contacts recently returned from travelling overseas ?:*
If so where?:

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All photographs & images on this website may not be used without prior consent/permission of the owner.
Sources:
Dreamstone Holistics (formerly Dreamstone Therapies)
(c) Can Stock Photo

DISCLAIMER

The treatments offered by Dreamstone Holistics are NOT a substitute for medical treatment.
If you have a medical problem, you should see your GP. I will NOT diagnose or recommend treatment.
Reiki, Crystal Therapy & Tuning Fork Therapy are, however, completely safe, non-invasive therapies and will complement medication or professional medical treatment.
If any doubt you should seek the advice of your GP.

Site last updated on Thursday 23rd November 2023

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