Patient Forms

During the Covid 19 Pandemic, in order to reduce contact time with patients, we are asking patient's to complete, Medical History and Consent Forms at home.  If you have booked an appointment, you should  have been sent an electronic form to  complete with your appointment reminder or confirmation. If you are unable to use the electronic form, you can download the forms below.

Please could all patients, who have attended previously, complete and sign the: 

  • Podiatry Consent Form during CV-19

If you are a new patient, or your medical history/medications have changed, or you have not had an appointment in over a year, please complete and sign the: 

  • Medical History  & Consent Form during CV 19.

Then if possible scan or photograph and return by email or text to:

waterhousepodiatry@gmail.com

Tel: 07437 015754

You may also bring your completed form with you  at your appointment.  

Alternatively, I have paper copies of these forms and you may complete these at your appointment.

Podiatry Consent Form during CV19

Please could all patients complete who have attended previously).

 

Medical History & Consent Form during CV19

 

Please complete  if:

You are a new patient, if  your medical history/medications have changed, or you have not had an appointment in over a year.

 

Wendy Waterhouse

HCPC Registered

Make an Appointment
Find us 

Waterhouse Podiatry & Chiropody

Due to flooding in February 2020, we are temporarily 

working from:

Hebden Bridge Town Hall

St George's St,

Hebden Bridge

HX7 7BY

Tel:  07437 015754

waterhousepodiatry@gmail.com

 

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