top of page

Consent form 

This form is for all existing and all potential members who wish to receive physiotherapy at The Brightwell, The West of England MS Therapy Centre or The Bristol Therapy Centre.


You need to fill this form in before you physically attend or virtually attend a physiotherapy session.


You only need to fill this form in once. 

If you are at high risk from coronavirus you're advised to follow the shielding advice issued by Public Health England to protect yourself. If this is the case you may not be offered a face to face appointment at the Centre. However, you will still be eligible to access our online, virtual appointments. If you are continuing to shield we also advise you to look at the self-management tools offered by the NHS.


  • A new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)

  • A high temperature – you feel hot to touch on your chest and/or back (you do not need to measure your temperature)

  • A loss or change to your sense of taste or smell - this means you’ve noticed you cannot smell or taste anything, or things smell or taste different to normal


Most people with COVID-19 have at least one of these symptoms.


If you have ANY of the main symptoms of COVID-19 you must;

  • Stay at home (self-isolate) - do not leave your home or have visitors. Anyone you live with and anyone in your support bubble must also self-isolate

  • Get a test - Get a test to check if you have COVID-19 as soon as possible . Anyone you live with and anyone in your support bubble should also get a test


To get a test visit

bottom of page