COVID questionnaire

As a Federation of Holistic Therapists (FHT) approved therapist I am required to carry out a full risk assessment that adheres to COVID-19 guidelines produced by the government and my professional association prior to any treatment. For more information, visit .

This COVID related questionnaire will need to be completed no more than 24 hours prior to your treatment. This can be done over the phone. Please feel free to contact me if you have any questions or concerns about this.

The following is an example of the typical questions I will ask and information I will need:
Your name
Date of treatment
Type of treatment

Do you currently have COVID-19 or any symptoms of COVID-19?

Yes ☐ No ☐

Please defer your treatment if you: are waiting for a COVID-19 test result; have recently tested positive for COVID-19; or have a high temperature, new continuous cough, or a loss or change to your sense of smell or taste. If you currently have symptoms of COVID-19 but have not yet used the NHS 111 online coronavirus service, please do so. If you have any other new or unusual symptoms, please discuss these with your therapist before your appointment.

Have you had COVID-19? Yes ☐ No ☐

If you have had COVID-19, please seek consent from your GP or consultant before treatment.

Does anyone in your household or support bubble have COVID-19 or symptoms of COVID-19? Yes ☐ No ☐

Have you been in close contact with anyone else in the past 14 days who has symptoms of COVID-19, or been contacted by the NHS Test and Trace service and told to self-isolate? Yes ☐ No ☐

If yes to either question, please defer seeing your therapist until it is safe to do so.

Are you classed as an extremely vulnerable person (high risk)?

Yes ☐ No ☐

If you are classed as clinically extremely vulnerable and require shielding, you will have received a letter from the NHS explaining this. Defer treatments until the government indicates that it is safe for you to leave home or have visitors providing non-essential care.

Are you classed as a vulnerable person (moderate risk)? Yes ☐ No ☐

Unlike people at high risk, those who are classed as clinically vulnerable will not have received a letter from the NHS. If you are unsure if you are clinically vulnerable, please refer to the NHS website at 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.

Please check your temperature on the morning of your treatment. If it is higher than usual, or if you have any other symptoms, please contact me to defer your treatment.

Please ensure that you follow all new procedures prior to treatment.