Covid-19 Pre Treatment Questionnaire

Please discuss with Emma any concerns, new or unusual symptoms in regards to feeling unwell. You can also use the NHS 111 online Coronavirus service for assistance.


Honesty is key so please respect the health of others and fill in this form with truthful representation of your current health.


Please scroll down to complete the questionnaire and for further information. 

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COVID-19 Pre Treatment Questions

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NHS Link for COVID-19 High and Moderate Risk Health Conditions


If you are classed as a clinically extremely vulnerable person (high risk) and require sheilding, you will have received a letter from the NHS explaining this. It is highly recommended to defer treatment with ELM until the government indicates that it is safe for you.


If you are classed as a vulnerable person (moderate risk) you will not have received a letter from the NHS. If you are unsure if you are clinically vulnerable, please refer to the NHS website. If you meet the definition of someone who is clinically vulnerable, please discuss this further with your therapist and seek consent from your GP, midwife or consultant before having a treatment with us.

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