Covid Screening Form
Please fill out all the required information.
Please note: Whilst all precautions are being taken to limit your exposure to COVID-19 and other respiratory diseases, we cannot guarantee that Total Health Care is free of any communicable disease. By attending face-to-face appointments at Total Health Care, you acknowledge this risk and will not hold Total Health Care, its staff or the practitioners liable under any circumstances.
i. Total Health Care requests that any aggressive, offensive and abusive behaviour not occur in communication with Total Health Care, whether in person, over the telephone, via email, etc. We ask that our staff be treated with respect at all times. We do not expect our staff to tolerate behaviour that we consider to be unacceptable.
i. By communicating with Total Health Care you agree to the above.
Please note that you will not be required to complete this form if you prefer to attend a tele-practice (tele-health) appointment.
Please complete this form in it’s entirety per person requesting to attend our practice in person eg. each Patient, each Patient’s parent(s)/carer(s), etc.