Terms and Conditions

DECLARATION

I agree to provide the clinic with my address and contact details, as well as details pertaining to my medical history (inclusive of current medications that I take).  I understand that these details are essential to the staff of the clinic being able to safely tend to my foot care needs.  I understand that these personal details will be processed by the clinic and will only be accessible to the staff of the clinic.  My personal details will not be processed or accessed by any other persons. I understand that my details will not be passed on to any third parties.  I agree that in the event of a medical emergency, my GP can be contacted and that any emergency services may access my clinical records in such an event.  I understand that my details will be retained for a period of up to 7 years after my last appointment (or the date of my 25th birthday if my last appointment was attended while I was under the age of 18) before they will be destroyed. 

By signing this agreement, I provide consent for ongoing foot care in line with my clinical needs.  Treatments will be explained to me by the attending clinician and I agree that I will seek clarity from said clinician if I am in any doubt or have any concerns in relation to my treatment.

I understand that in the unlikely event that I suffer a minor injury, such as a cut, during a treatment then there are some simple precautionary steps that ought to be taken to prevent infection.  I understand that it is possible that the injury could become more serious unless I take appropriate care.  Any such incident will always be recorded at the time.  I agree that if there has or may have been any injury as a result of a treatment then I will ensure that I notify the clinic at the time and will seek the clinic’s advice on any aftercare precautions that may be necessary.  If I am in any doubt as to whether I have suffered an injury, I will consult the clinic.  I accept that if I do not notify the clinic at the time, then it may be impossible to identify the cause of an infection and too late to take simple precautionary steps.  The clinic will not be responsible for the consequences of a failure by a patient to immediately notify it of any possible injury. 

Please note parents are unable to accompany their children into the clinic treatment areas. 

This clinic operates a ‘zero tolerance’ policy against any threatening or abusive behaviour to any staff members or other patients.

Signature of Patient ____________________________     Date __________________

For children under 18 years of age

Signature and consent of Parent/Guardian on behalf of patient: ____________________

Dated ____________________________________