Welcome back! We are so happy to have you back at our studio. Please complete the following form before beginning your session today.


We are required to keep this information on file for at least 28 days in accordance with the Victorian Government's COVID contact tracing guidelines. If you have any questions about this please let us know.

To find our more about how we are keeping our community safe during this time check out our New Appointment Policy


(We will take your temperature on arrival)

Have you been tested for COVID-19 in the past 14 days?
Have you been in contact with a person who is either a suspected or confirmed case of COVID-19 in the last 14 days?
Have you, or anyone you currently reside with, returned from overseas or interstate travel (including cruise ships) in the past 14 days?
Have you recently visited a known high-risk area with a cluster of cases?
Have you experienced diarrhoea, fatigue, loss of taste or smell in the past 14 days?
Do you currently have, or have you recently experienced, a fever (higher than 37.8 degrees celcius), or have a history of fever (eg. night sweats or chills)?
Do you currently have symptoms of cough, sore throat, runny nose, or difficulty breathing?

If you have answered YES to ANY of the above questions, we may be required to delay your appointment until after a 14-day period of self-isolation has been completed and you are asymptomatic or you receive your COVID-19 test results.

Are you a healthcare, aged or residential care worker with direct patient contact?
Are you aged 70 or over?
Do you currently have diabetes or a compromised immune system?

If you have answered YES to ANY of the above questions, we will confirm with you whether we need to defer your appointment at this time.  

Suite 604, Level 6, 125 Swanston St

The Century Building, MELBOURNE VIC 3000

Tuesday - Friday: 10am - 8pm

Saturday: 10am - 5pm

Sunday & Monday: CLOSED

0468 852 555


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©2020 by Pure Wellness Studio | ABN 53 627 466 595 | Website design by More Than Your Brand 

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