Pre-appointment wellness screening checklist

Before your appointment Dr Lashbrooke will invite you to complete the pre-appointment wellness screening checklist. This can be done during a phone call with Dr Lashbrooke before your appointment. We have shown the checklist below to help you understand what will be asked and so that you can think of any questions you may wish to ask. 

SYMPTOM CHECK:

Have you experienced any of the following symptoms within the last 14 days?

  • Temperature or feeling feverish

  • New cough

  • Shortness of breath

  • Sore throat

  • Flu-like symptoms such as fatigue, headache

  • Nausea or diarrhoea

  • Chills or shivering

  • Muscle pains or rash

  • Loss of taste or smell

   

Have you been diagnosed or suspected of having COVID-19?

  • Have you had a throat and nasal swab? 

  • Did you test Positive or Negative?

  • Date of Test

  • Have you had an antibody blood test?

  • Was it Positive or Negative?

  • Date of Test

FAMILY AND CLOSE CONTACTS:

Are any of your family members or immediate/close contacts currently sick or experiencing:

  • Fever, Cough, Shortness of breath or Flu-like symptoms? 

  • Sore throat, Muscle aches, Fatigue, Nausea & Diarrhoea? 

 

Have any of your family members or immediate/close contacts been diagnosed with COVID-19?

  • If yes, when? 

RECENT TRAVEL:

Have you recently travelled internationally, travelled within the UK or attended a public event in the last 15 days?

  • If yes, where and when?

 

Has any of your family or close contacts recently travelled internationally, travelled within UK or attended an event in the last 15 days?

  • If yes, where and when? 

MEDICAL HISTORY

Do you suffer from any of the following conditions?

  • Diabetes mellitus?

  • Cardiovascular disease?

  • Hypertension (high blood pressure)?

  • Chronic (long-standing) lung disease?

  • Immunosupression (e.g. due to medication)?

  • Cancer undergoing active treatment?

 

Are you aged 70 or older?​

 

Are you pregnant?

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