COVID-19 SELF-DECLARATION QUESTIONNAIRE

Unfortunately, with the on going Covid-19 situation, it is vital that we follow a strict protocol with our consultations/surveys.

In the interest of our safety for your and our families and the wider community, we ask that you please complete the following questionnaire/self-declaration in advance of our meeting.

I will be wearing a face mask upon arrival and could we please request that you and any other people present in the home - wear a face mask for the duration of our meeting.

Our consultation will be as brief as possible, however, if weather permits - we can discuss some aspects outdoors or via a follow up telephone call/email.

If you have any issue with this, please just get in touch PRIOR to our meeting.

Your co-operation and support are greatly appreciated at this difficult time.

If you answer “YES” to any of the questions 1-5, please get in touch as we may need to re-schedule the meeting for a later date.