Health Review Questionnaire

THE BRIDGE X THE LONDON HOUSE OF WELLBEING

Thank you for booking in with us. To assist your Health Review with us, we ask that you please complete this questionnaire as fully as possible.

If yes, please complete the information below with your GP's details:

We recognise that when you provide us with personal information you are trusting us to take good care of it. Please refer to our Privacy Policy for more information about how we collect, use, and protect your data.

I consent to a blood sample being taken from my finger to see whether the test/s I have indicated above are positive or negative.

IMPORTANT NOTE: Our tests are not a substitute for seeing your Doctor, especially if you are suffering symptoms. We will interpret your results based on National Guidelines. You will be advised to see your Doctor for any follow-up action.

‘Take control of your health today’

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