Consent Form

Information & Consent Form

Risk of Coronavirus (COVID-19) Transmission at Banchory Spinal Health We are asking all patients to read the below carefully and electronically submit the below form to confirm their understanding and agreement before attending the clinic for their appointment.  We thank you in advance for your understanding and co-operation.

The Government published a Statutory Instrument on 26th March 2020, no. 350 ‘The Health Protection (Coronavirus) (Restrictions) (Scotland) Regulations 2020’ confirming that it is lawful for a chiropractic/osteopathic practice to remain open. It further defines those people who are recognised as vulnerable for the purposes of this document. Banchory Spinal Health has conducted a thorough risk assessment to ensure adequate levels of safety are implemented and maintained. We are following the most up-to-date Government and Health Protection Scotland guidance and have put in place stringent patient triage, hygiene, sanitation and infection control protocols to protect our patients and team members. Despite these precautions, there is a risk of transmission of the Coronavirus (COVID-19) and it is important that you understand the risk. We have provided the information below to help you decide if you wish to continue with your care at Banchory Spinal Health and remind you that you are under no obligation to do so.

Precautions that Banchory Spinal Health is following:

All patients contacting us for an appointment are triaged by your practitioner over the telephone to establish:

  • whether symptoms are present
  • If they are self-isolating
  • If anyone in their household has symptoms or is self-isolating
  • Or they have been in contact with anyone with COVID-19 symptoms.

We enforce a strict policy that anyone with any COVID-19 symptoms must stay away from the clinic.

A triage is conducted at the Clinic, including a temperature check and a chat about your pain. A strict cleaning, sanitation and infection control protocol is adhered to – please ask if you would like to see this document.

The layout of the clinic and timing of appointments have been adapted to maintain social distancing as much as possible. Your practitioner will be wearing Personal Protective Equipment (PPE) for everyone's protection.

Banchory Spinal Health is committed to ensuring that every measure is in place to minimise the risk of exposure to COVID-19, we cannot guarantee there is no risk to you as a result of attending the clinic.

People can catch COVID-19 from others who have the virus. The disease can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets. The risk of catching COVID-19 from someone with no symptoms at all is very low. However, many people with COVID-19 experience only mild symptoms. This is particularly true at the early stages of the disease. It is, therefore, possible to catch COVID-19 from someone who has, for example, just a mild cough and does not feel ill (World Health Organisation).

Eligibility for Care. We are currently accepting patients from the below defined "at risk" groups following a triage process and will assess each individual case separately:

  • Pregnant
  • Over 70
  • Have a long-term health condition/ Underlying Medical Conditions as listed below:
    • Chronic (long-term) respiratory diseases, such as asthma, chronic obstructive pulmonary disease, emphysema or bronchitis
    • Chronic heart disease, such as heart failure
    • Chronic kidney disease
    • Chronic liver disease, such as hepatitis
    • Chronic neurological conditions, such as
    • Parkinson’s disease, motor neurone disease, multiple sclerosis, a learning disability or cerebral palsy
    • Diabetes
    • Problems with the spleen, such as sickle cell disease or removal of the spleen
    • A weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or chemotherapy.
    • Being seriously overweight, with a body mass index of 40 or above.

Consent to receive care at Banchory Spinal Health

Please check all of the boxes below before submitting your form:

✓  I have answered all questions (triage) relating to my potential exposure to Coronavirus (COVID-19) truthfully.
✓  I understand that there is a potential risk of transmission of Coronavirus (COVID-19) as a result of attending the clinic and/or receiving treatment.
✓ I have had the opportunity to ask all the questions I wish to, and all my questions have been answered to my satisfaction.
✓ Should I have further questions that arise between submitting this form and up to and including when my appointment starts, I will raise these with the Clinical team member before any treatment takes place.
✓ I have read, agreed to and understood the statements above relating to Coronavirus (COVID-19) risk and consent to receive care at Banchory Spinal Health.