Class Face to Face Consent (Covid -19)
-The Covid-19 out break means that physiotherapists have had to radically change their practice to mitigate the risk of infection for clients and for themselves. This means that the patient needs to be aware of what measures have been taken to protect both parties, and what measures they need to take as attendees. --A thorough Risk Assessment of the area has been taken and will be reviewed regularly
Consent to participate in classes
-To mitigate risk, the physiotherapist will:-clean all contact points in the studio before and after classes eg door handles, banisters and the floor cleaned before and after each class or useage. -maintain 1m+ social distance where possible. -No touching of exercise equipment bar own. -Physical contact with any attendee will only be on agreement between parties for correction of exercise -wash hands/forearms for minimum of 20 secs and use hand sanitizer before and after session. -maintain windows open at all times-ensure session has minimal aerobic content
To mitigate risk, the patient will:
-wear face mask (optional) -come to class changed and ready to exercise -stay in car until invited into the studio by Physiotherapist -bring own equipment to class consisting of Yoga mat, 90cmx 15cm foam roller, Yoga block (or hard backed book) mini resistance band -maintain 2m social distancing at all times from other participants and respect their requirement for this -wash hands/forearms for minimum of 20 secs and use hand sanitizer before and after class
-To mitigate risk, patient AND physiotherapist will:
- monitor own health in respect of Covid-19 symptoms, and inform each other IMMEDIATELY if aware of any of the following, so that self isolation can commence: HIGH TEMPERATURE NEW CONTINUOUS COUGH LOSS OF/CHANGE TO SENSE OF SMELL/TASTE I can confirm that I am happy to attend PhysioCore classes at Bowdon Sports’Club Studio during this time of the coronavirus pandemic and that I am not in the extremely vulnerable group. I am happy that a thorough risk assessment has been undertaken and agree to the above. Payment will be online ahead of the session
Name*
First Name Last Name
Phone Number
Phone Number
Email
example@example.com
Which class day and time do you attend?
By ticking the box below you consent to the above plus your details being shared for track and trace purposes if required
I consent
Date*
Month Day Year
Date
Signature*
Clear
Should be Empty:

Class Face to Face Consent (Covid -19)

Consent to participate in classes

To mitigate risk, the patient will:

-To mitigate risk, patient AND physiotherapist will: