Covid-19 Consent Form

Please carefully read the information below before booking and attending any of our treatments.


I, the undersigned, hereby certify that I have not had, in the last 48 hours, any of the following symptoms: 

  • Fever or chills
  • Cough or worse than usual cough
  • Unusual fatigue
  • Unusual shortness of breath when I speak or make a small effort
  • Unusual muscle pain and/or aches
  • Unexplained headaches
  • Loss of taste or smell
  • Unusual diarrhoea

I am aware of, and agree to the following safety procedures once at the clinic: 

  • I will wash my hands upon entry with hand sanitiser provided, or soap and paper hand towels
  • Clinical masks will be worn by staff for any work with under 2-meters’ distance.
  • All areas of the clinic that have come into contact with prior clients, me, or any staff will have been disinfected.

I, the undersigned, give my consent for the following:

  • The therapist can approach closer than 2 meters and to be able to physically contact my body to treat Reflexology, Aromatherapy Reiki MLD & Neal’s Yard Holistic Facials.
  • I recognise and accept the increased risk of COVID-19 transmission.
  • I accept responsibility for my part in agreeing to receive treatments.
  • I agree to report any COVID-19 symptoms within 14 days of leaving clinic.
  • If I do develop COVID-19 symptoms within 14 days of leaving the clinic, after reporting my symptoms, I am aware that all parties involved must activate exposure protocol, ie. to self-isolate for 21 days.
  • I must follow the HSE guidance regarding COVID-19 and RIDDOR (reporting of injuries, diseases and dangerous occurrences regulations 2018).