Contact Us

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Address

Pembrokeshire College
Haverfordwest
Pembrokeshire
SA61 1SZ

Phone

Working Days
01437 753 164

Pre-appointment Questionnaire

Please note:

  • Only attend at your appointment time.
  • Please ensure you are on time – if you are late this may result in your appointment being cancelled.
  • Please attend your appointment unaccompanied.
  • Limit the personal possessions you bring with you (leave securely in your car where possible).
  • Upon arrival you must use the hand sanitiser provided.
  • You are required to wear a mask during your appointment. Failure to do so will result in your service needing to be cancelled.
  • Do not touch or remove your mask during the appointment.
  • Drinks will not be provided however clients are welcome to bring their own.
  • Contactless payments preferred unless you have made payment prior to your appointment.
  • If you experience Covid-19 symptoms after your appointment please contact us immediately.

Date of appointment (required)

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Have you or anyone in your household had any of the following symptoms in the last 14 days: dry cough, fever, high temperature, shortness of breath, loss of sense of taste or smell, sore throat?
YesNo

Have you been in close contact with anyone with confirmed COVID-19 in the last 14 days?
YesNo

Are you in the high risk category (clinically extremely vulnerable) as defined by the UK government?
YesNo

Are you in the moderate risk category (clinically vulnerable) as defined by the UK government?
YesNo

If you are unsure about the risk categories above please click here to check the UK government guidance.

Any additional comments:

By submitting this form you are confirming that the above details are correct at the time of completion.