I understand that the physiotherapists at KTB have a legal obligation to collect and process personal information in order to provide the most appropriate treatment for my needs. I am happy that the information provided will be uploaded onto a secure software database in line with GDPR regulations and that my information will be used for the purpose of maintaining appropriate contact details and in order to be able to provide a safe and effective physiotherapy service to me.

I confirm the information I have given is accurate and hereby give consent to receiving physiotherapy from KTB Rehabilitation on this and any subsequent occasion.

Private Patients Self Funding their Appointments

I have been advised of the current fees charged by the centre at the clinic and understand the payment terms.
I agree to pay at the time of booking each appointment or to secure my appointment with a £15 deposit.
I understand that payment of Pilates courses and block booked courses are non-refundable.

Non Attendance Policies

- Over 24 hours notice to cancel - no charge
- Less than 24 hours notice to cancel £15 fee 30 min appt; £30 60 min appt
- Less than 24 hours notice on more than two occasions - full fee

Insurance patients on policy contracts or who have been referred to us for treatment

You must give 24 hours to cancel an appointment. Any cancellations with less than 24 hours notice or any failures to attend will be reported to your insurance company who may charge you for the session; reduce your allocation of physiotherapy treatment or discharge you.

The only method in which an appointment can be cancelled or changed is via a telephone conversation.

You consent to us providing your referring company with clinical notes and consent to them providing your notes to any other party/company involved in your treatment. This will be confined to parties involved in your treatment only and your details will not be provide to any other outside party that is not involved in your case.

Private policy patients agree to cover any fees that their private health insurance has given notification that they will not be covering the charge.

Prescribed Pilates Classes

Our Pilates classes are paid for in advance for either a six week course or a pay as you go session. You will reserve a place on a set session and will be expected on that session each week from the date that you pay.

I understand that it is my responsibility to inform the Physiotherapist taking my class of any change in my medical or health status and also of any pain or discomfort experienced during a class.

Allow 24hrs cancellation notice. We do have a flexible policy whereby if you are unable to attend your booked session you can inform reception and change this class to another time within your six weeks according to availability.

Patients arriving more than 20 minutes late for their class will be refused entry for safety reasons and to avoid disruption to other class members

I have read and understood the non attendance policy for KTB. I have read the privacy policy for the company. Any questions that I raised were answered to my satisfaction by a member of KTBs administration team. As required by data protection we have a duty to inform you that you can withdraw your consent for any of the permissions detailed below at any time. Should you wish to withdraw consent please discuss this with a member of staff in the first instance.