Consultation Information

So that we can provide your treatment in the safest way possible we require you to provide the information requested below. This information is only used in relation to your requested treatment.

Name Address Post Code
email Tel Date Of Birth

Current Medical Conditions
Allergies
Diabetes
High/low blood pressure
Varicose Veins
Joint/muscular pain
Conjunctivitis
Claustrophobia
Warts/verruca’s
Fungal infection
Athletes Foot
Back problems
Epilepsy
Heart Condition
Are you pregnant?

Current medication Recent Operations Any other information that may help us?

Covid-19

Have you or anyone in your household had COVID-19? Have you or anyone is your household had any of the following symptoms in the last 14 days: dry cough, fever, high temperature, shortness of breath, loss of sense of taste or smell? Have you been in close contact with anyone with confirmed Covid-19 without wearing appropriate PPE? Have you travelled outside the UK in the last 14 days? Are you in the high risk category (clinically extremely vulnerable) as defined by the UK government? Are you in the moderate risk category (clinically vulnerable) as defined by the UK government?

Appointment Guidance

Please only attend at your appointment time.
Please ensure you are on time- if you are late it may result in your appointment being cancelled.  
Please limit personal possessions you bring with you (leave securely in your car where possible).
Please wear a mask to your appointment, they are also available to purchase from reception.
Upon arrival you must wash your hands and use the hand sanitiser provided.
Contactless payment only unless you have made payment prior to your appointment.
If you experience COVID-19 symptoms after your appointment, please contact us immediately.
May we use your email address to send you marketing offers?
May we send marketing offers via SMS?
I agree for The Retreat Barhill to use this information in relation to my treatment.

The information you have entered will be used only for the suitability of our treatments and will never be shared with other parties. If you have any other questions or wish to make a booking email info@theretreatbarhill.com or call 01954 249986