COVID-19 Consent | Kimdecinabio

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.

If you are feeling ill or have been in contact with someone who has tested positive for Covid-19, 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.
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.

COVID-19 RISK CONSENT

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.

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

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.

If you are feeling ill or have been in contact with someone who has tested positive for Covid-19, 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.

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.