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Vestibular Patient Registration

To register, please take the time to fill out the information below.

Dizziness ScaleNo DizzinessSometimes DizzyOften DizzyVery Often DizzyMost of Day Spent DizzyDizziness Scale
I understand that vestibular treatment may temporarily worsen my symptoms. I may not be safe to drive immediately afterwards Required
Do you have any other Medical Conditions

I agree to give 24 hours notice if I cannot attend my appointment (to be given to someone in need of urgent treatment). If I do not give notice I agree to pay a fee of €30. If I do not attend my appointment and I have not called, I agree to pay the full consulting fee.

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