Name Email Have you got a high temperature? Yes No Do you have a persistent new cough? Yes No Have you recently lost your sense of taste/or smell? Yes No Have you had any of these symptoms in the last 14 days? Yes No Have you or anyone directly close to you had COVID-19, been tested for it or received treatment for it? If so, when? Are you or anyone you have been in close contact with self-isolating at the moment? Yes No Are you shielding anyone you have close contact with at the moment? Yes No Have you followed social distancing guidelines as set out by the government? (Please be aware it is important to answer this truthfully). Yes No Acceptance of new Covid-19 protocols By checking this box, you confirm that you have read, understood and agree to the new Covid-19 protocols at Radford Holistic Therapies that have been implemented. You can view the policy online. Send