Family Visit Information Request

Family Visit Information Request

I am so sorry to add to your list of things to do.

Sadly before I can make a home visit, I will require the form below to be completed. Please make sure that you give as much information as you can when completing this form.

I look forward to meeting you and your family.

Kind regards

Jon Matson-Higgins

Please make sure that your pets are secure during my visit. If you have no pets please place NA in the box.

COVID-19, Colds and Flu

I must take all the relevant precautions when visiting you to help protect you, myself and the other families I am working with at the current time. I complete a lateral flow test each day and will wear a mask whilst I am with you. I am also happy to conduct family meetings via Zoom or FaceTime. If you or anyone in your household test or is currently positive for COVID-19 or has a cold or the Flu, please advise me as soon as possible.
If you have ticked that you are not fine, please give details regrading the current situation.

What is 7+4?

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