Are you, or the person needing the booking, experiencing any of the following?

Chest pain or chest tightness

Severe difficulty breathing

Extreme pain

Severe burns

Serious accidents or trauma

Severe bleeding

Overdose or suspected poisoning

Lip or tongue swelling

Sudden weakness or numbness of the face, arm or leg

Unconsciousness

Suicidal thoughts / impulses

Pregnancy – heavy bleeding, abdominal pain or in labour

Yes
No