By signing this form, I consent to the processing and retention of my personal information and medical data for the purposes of assessment, treatment and management of my health, well-being and fitness at Elements Phsiotherapy & Sports Injury Clinic. This includes the use of my email and/or telephone number to amend or remind me of appointments via our appointment booking system, as well as provide technical information and follow-up materials associated with my agreed treatment.

All data will be collected and stored confidentially and safely, complying with the General Data Protection Regulations (GDPR) – it will not be used for any other purpose. If you wish to see our full GDPR policy please ask your clinician or visit our website via www.elementsphysio.co.uk.

If you require a referral, or for us to share the information with any other professionals, we will only do this after gaining your written permission to do so each time.

Please note, you can withdraw or amend your consent at any time.