Covid-19 Health Declaration

How are you feeling today?

Have you experienced any of the following symptoms within the last 14 days? Please tick if applica le.
Have you travelled internationally within the last 14 days?
Have you come into contact with any suspected, probable or confirmed COVID-19 cases within the last 14 days?
Please read each of the following statements carefully and tick to indicate that you agree.

Your Signature

Get in Touch

8 La Valla Court, Junortoun VIC 3551

info@focuswithinhw.com

0438 449 507

Mon - Thurs: 9:00am to 5:00pm

Friday: 9:00am to 4:00pm

Saturday: 10:00am to 4:00pm

Sunday: By appointments only

©2021 by Focus Within. Proudly created by icebergdigital.marketing

Girl with Arms Stretched Out
Subscribe to receive exclusive news & updates

Follow-us on social media

  • Instagram