New Patient Form - general details and Covid screening


Thank you for booking your treatment session at Nova Clinic. To enable us to provide safe treatment to you and other patients we ask you to, please fill in this form, prior to attending our clinic.. We are offering these special sessions to help you relax, restore a sense of well-being as well as address your specific health issues. Please note that a strict no talking policy applies during these sessions as we want to create a tranquil environment with gentle meditation music and candle light. Payment can only be made by cash, as there is no reception in operation on the day.  If your health condition is complex than a full initial consultation is recommended (click here to request full consultation).

Please fill in this form in full, to assist your practitioner in providing the best possible treatment for you: 

In order to provide safe treatment, please tick any that apply to you:
Please select treatment you require:

Thanks for submitting!