COVID-19 RISK CONSENT

I knowingly and willingly consent to receive elective Biokinetic treatment by Kimberly-Ann Decina during the COVID-19 pandemic. I also understand and declare that:

  • The COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious.

  • Biokinetic treatment may possibly take place with the patient in very close proximity to the practitioner. This potentially exposes the patient and the practitioner to the COVID-19 virus.

  • Due to the frequency of visits of other Biokinetic patients, the characteristics of the virus, and the characteristics of the Biokinetic practice, that I have an elevated risk of contracting the virus simply by being in a Biokineticists office, or the Biokineticist visiting my home. (This risk includes, but is not limited to: A positive Covid 19 diagnosis, extended quarantine/self-isolation, additional tests, hospitalisation that may require medical therapy, Intensive Care treatment, possible need for intubation/ventilator support, short term or long tern intubation, other potential complications and the risk of death. In addition, after my elective treatment/procedure/surgery, I may need additional care that may require me to go to an emergency room or hospital).

  • It is still recommended where possible and practical that consultations be held via video conferencing software or through Telehealth technologies.

  • I confirm I am seeking treatment for a condition that cannot be done effectively or practically via Telehealth technologies.

  • I confirm that I am not presenting ANY of the following symptoms of COVID-19: Fever, Shortness of Breath, Dry Cough, Runny Nose, Sore Throat

  • High risk patients relating to the severity of COVID-19 are persons over the age of 60 and persons who have pre-existing medical conditions such as: asthma, chronic lung conditions, hypertension, autoimmune diseases, organ transplants, cancer, Immunocompromised, Obesity (BMI over 40) and Liver or kidney conditions.

  • I confirm that I do not fall into any of these high risk categories, and if I do I give consent to receive Biokinetic treatment and am fully aware of my elevated risk for COVID-19.

  • In person consultations and treatment will only be done for high risk patients if absolutely necessary and in emergencies.

  • I am aware of the risks involved with the spread of the COVID-19 virus and the risks it may hold to my health and the health of others I come in contact with. I accept those risks and hereby give my express permission to conduct treatment at my request.

COVID-19 PRACTICAL GUIDELINES

I have read and understand the practical guidelines as set out hereunder and confirm that I will comply thereto and prepare accordingly.

 

  • Patients will be pre-screened via a questionnaire the day before consultations, and requested to take appropriate action if they are presenting with any risk symptoms or history.

  • If you are feeling ill, we kindly ask you to call/whatsapp to cancel/postpone your appointment.

  • Patients will be stopped from entering the practice if the patient hasn't complied with proper control measures.

  • Patients are requested to arrive on-time for appointments, if they are early they will be asked to wait in their cars until their appointment time so that we can avoid overcrowding in the waiting room.

  • All patients will be sprayed with hand sanitiser upon entry.

  • All patients must wear a face mask to enter the practice.

  • Face shields will be available on request for clients to use during their session

  • The Biokineticist will keep her mask on throughout the duration of your session.

  • On arrival, patients will again be screened for risk factors including the taking of a temperature.

  • Between consultations, the necessary hygiene/cleaning protocols will be done by the practitioner and/or their staff compliment and this may cause a delay and prolong waiting periods.

  • Patients are requested to avoid touching anything inside the practice that is not necessary for their treatment.

  • Patients are requested to remove any excess jewellery and leave them at home as it can be carriers of infection droplets.

  • Massage patients are requested to bring along their own towels (1 x big, 1 x small).

  • Exercise patients are requested to bring along their own sweat towel.

© 2020 by Kim Decina Biokineticist