CLIENT COVID-19 FORM

Helping us to stay safe.

To ensure your treatment is relaxing as possible, we have added extra touches to assist with your realxation.

HEPA filtered air system will be in use throughout your treatment.
Towels and blankets will be changed and washed after each client.
Surfaces and room will be sprayed with antibacterial cleaner and sanitiser.
Bookings will not overlap. Minimising client to client contact.
Payment: Contactless payment is prefered – we accept all majour debit and credit cards, apple pay and android pay.

Thanks for booking your treatment with us.

As you can expect a few things have changed due to COVID19. Please complete this form and click submit when you’re done.

All questions relate to the last 14 days, unless stated.

This form must be filled out before any treatment can be performed.

Thank’s for your understanding.

Making Reiki safe

Name

Email

Contact number

House name / number

Street

Town

Postcode

High temperature

NO YES

Continuous cough

NO YES

Loss of smell

NO YES

Loss of taste

NO YES

Feeling unwell within 14 days

NO YES

Awaiting COVID results

NO YES

Contact with POSITIVE COVID person

NO YES

Hands must be sanitised on arrival

NO YES

Mask or face covering must be worn

NO YES

NO toilet facilities are available

I'M OK WITH THAT THAT'S AN ISSUE

NO group bookings are allowed

THAT'S OK THATS AN ISSUE

pay via card - contactless is accepted

CARD IS OK PAY WITH CASH

Allergies that would effect your treatment

Any other information that might be relevant or needed for your treatment.

Please click the box after reading the information.

I agree that the information I have provided is correct. If there is any change to my circumstances I will inform myholisitcs.me as soon as possible. Call: 07960 123100 or email brian@myholistics.me

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See you soon!