Dear Patients

Please find below our Covid-19 Patient Consent Forms and New Patient Forms. If you are new customer you will need to fill both forms in and sign them and bring them with you to your appointment or complete them and email them to if you would like us to print them off for you.  We can also send them to you by WhatsApp on request should you wish. 

The forms are set out below. In the first box below is the COVID-19 CONSENT FORM in Word and in PDF depending on what works best for you. Word Documents tend to be easier to fill in if you do not have Adobe Acrobat. PDF documents work on most computers however and are easy to print off. 

In the second box is the NEW PATIENT QUESTIONNAIRE . You will also need to fill this in if you are a new patient. If you have attended the clinic before you do not need to fill this in but you will still need to fill in the Covid19 Patient Consent form. 

Filling these forms in at home makes the clinic safer for everyone as it reduces contact time and allow us to focus on treating you in a safer environment. You can print them off and bring them to your appointment or you can fill them in on your phone or computer and email them to or attach to a message to 07906 812995.

Thank you for taking these additional steps to keep you and all our patients safe during this period.


The Hoole Acupuncture Clinic