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YOUR HEALTH DECLARATION

This electronic Health Declaration is strictly confidential in compliance with GDPR regs.

It is essential that you fill in all the fields below.

If you answer 'YES', please explain.

I undertake to keep the therapist updated on my health, should there be any changes to the answers given in next TEN DAYS.

I un
derstand that COVID-19 is passed by close contact with others, is still present in Cardiff and that people without symptoms may be infectious.

I understand that City Marshall takes every precaution to ensure my health and safety, but risk of infection is still possible.

By submitting this form I here by consent to take part in and adhere to the Welsh Test Trace and Protect protocol.

DATE OF BIRTH

 

*SEVEN CLASSIC COVID SYMPTOMS The ASK ZOE Symptom Tracker App has researched over 4m people. Having any of the additional four symptoms does not mean that you have COVID-19. However, you might want to consider getting tested. A NEW RASH, meaning a Hive-type skin rash on your feet or hands. This can be itchy or develop as a ‘prickly heat’ or chicken-pox type rash anywhere on the body. Sometimes known as COVID toes.

OUR ADDRESS :

QUAKER MEETING HOUSE
43 Charles Street
Cardiff, CF10 2GB


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cardiff massage at quaker meeting house. City Marshall has now re-located to the Quaker Meeting House along Charles Street


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