Cliniqapps

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COVID-19 (CORONA VIRUS) SCREENING QUESTIONS

Have you or anyone you've been in close contact with travelled overseas in the last 14 days?*

Yes
No

Have you been in close contact (<1.5m) or sustained (>15 minutes) with someone with a confirmed case of Coronavirus (COVID-19)?*

Yes
No

Are you currently experiencing any of the following symptoms:*

Fever (>37.5 degrees celsius)
Cough
Sore Throat
Shortness of breath
None of the above

Late Cancellation and Non-Attendance Policy

We require a minimum of 4 hours notice for appointment cancellations. If you cancel your appointment without providing adequate notice during business hours, you will be charged 50% of fee of the service.

After-hours cancellations will be received at 8:30am the next business day.

If you fail to attend an appointment without providing notice, you will be charged the full fee of the service.

We are a busy clinic and have people waiting for appointments, so we appreciate a phone call if you are unable to attend or if you are running late for your appointment.

*Cancellation or non-attendance fees are not covered by Work Cover, DVA, or Insurance companies and you will be invoiced personally.

Do you accept and agree to our Late Cancellation and Non-Attendance Policy?*

Yes
No

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New Patient Information Form