Covid Screening

Ensuring the safety of our patients and staff

COVID-19 Screening

Please complete the following before making a booking

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Have you experienced any of the following symptoms?


  • Fever (high temperature)
  • Cough
  • Sore throat
  • Myalgia (general weakness)
  • Loss of taste (ageusia)
  • Loss of sense of smell (anosmia)
  • Body aches
  • Nausea/vomiting/diarrhoea
  • Shortness of breath

  No        Yes

 


I hereby certify that the information I have provided in this form is complete, true and accurate and I give Sports Medicine Africa permission to validate the information provided. In line with the Protection of Personal Information Act, you are required to give Sports Medicine Africa permission to validate the accuracy of information provided. Visitors will not be permitted to enter the practice unless this form has been completed prior to booking an appointment.


  No        Yes

 


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