SELF-DECLARATION FORM

Due to the ongoing and rapid changing situation with the novel-coronavirus (COVID-19), we have made it mandatory for our patients to fill this self declaration form below. Depending on this form, HealYos will assign the physiotherapist/doctor on call for a visit at your location. Every patient must complete this form prior to their appointment and submit it.
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1. Do you have following any of following flu-like symptoms ?
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please upload your recent report
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**The health and wellbeing of our community is our first priority therefore HealYos reserves the right to postpone the treatment/service of its patients under certain circumstances**
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