This page is for you if you are At Risk, may have COVID and need to self isolate and/or have preference for a Consultation and Treatment Programme over the phone or by video link.

If you are a New Patient to the clinic and you have been recommended to us by your GP please fill this form out electronically (using fill & sign Adobe Acrobat Reader) before your appointment or if you are self referring please fill this form. If you are a Returning Patient, have a New Complaint or exacerbation of an Old Complaint you can find the appropriate forms here. Please fill out and return these well before we speak to you so we have a chance to look at them .

For information on what you need to know before giving your consent to our advice and self treatment please read this.

To learn more about what to expect, how to prepare yourself well so you have a good consultation and your consent and understanding of the potential data protection risks please follow the links.

 

 

 

 

 

 

 

Please send to reception@back-in-action.com once you’ve completed it. If you have any problems please contact us for some help.

In the mean time if you want some self help advice to ease your pain please check here.