Consent To Physiotherapy Treatment

The nature of therapy is such that close body contact and touching will probably form part of your treatment. You will be required to remove items of clothing. Physiotherapy treatment may consist of manual therapies, electro therapies, exercise therapies and allied procedures. Your therapist will discuss treatment options including benefits and significant side effects. Patients may experience slight soreness following treatment - this is perfectly normal. All patients are entitled to be chaperoned during their treatment if they so wish. Please make this clear prior to commencing treatment.

I wish to be accompanied during my treatment YesNo

I understand that a remote / virtual consultation will only be recorded at my request YesNo

Following an examination and assessment, a treatment programme if appropriate will be explained to me.

I ACCEPT A CANCELLATION CHARGE WILL BE IMPOSED IF LESS THAN 24 HRS NOTICE IS GIVEN. THIS WILL BE THE FULL TREATMENT FEE.

I understand that my GP/consultant will be informed of my attendance and progress, unless I request otherwise

Private Health Insurance

I understand that I am liable for any excess/limitations/or lapsed policies not accepted by the insurers.
Those patients whose health insurance policies require re-authorisation (by insurers/GP/Consultants) must provide this in writing prior to commencement of physiotherapy treatment.