PATIENT DECLARATION

I am well upon entering the clinic. I have no symptoms of respiratory infection such as raised temperature, a sore throat, a cough, experiencing chest discomfort or difficulties with breathing (regardless of travel history)I have not travelled overseas in the last 14 daysI have not been in close contact with someone who has travelled overseas in the last 14 daysI am not living with someone who has been advised specifically to self-isolate because of close contact with someone who is a probable, suspected or confirmed case of COVID-19I have not been in close contact with someone who is a suspected or confirmed case of COVID-19