COVID-19 Questionnaire
We want you to be well and safe. The questionnaire is designed for the safety of you and the clinic staff. If you or we think you have a high chance of currently being infected with coronavirus, you should delay you attendance until a safer time and we may advise this.
Have you been tested for coronavirus?
Clear selection
Have you had fever in the past two weeks?
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Have you had a cough in the past two weeks?
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Have you had any symptoms suggestive of a viral infection within the last two weeks, such as muscle pain, lethargy, diarrhoea or vomiting, or loss of smell?
Clear selection
Have you been exposed to anyone who has had COVID-19 in the past two month?
Clear selection
Have you travelled outside the UK in the past two weeks? if you did, where?
Clear selection
Submit
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