COVID-19

 

PRE-APPOINTMENT WELLNESS

 

SCREENING CHECKLIST

Please complete and submit the following form the day before you visit us.

Have you experienced ANY of the following symptoms within the last 14 days?
Have you been diagnosed or suspected of having Covid-19?

07791 983895

First Floor 1, Victoria Rd, Stoke-on-Trent ST4 2HE, UK

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