Book a Home Visit – Evsen Taskum

Evsen – In-Home Physiotherapy Booking

Contact & patient details

Who is completing this form?

Patient (Myself)

Family Member / Carer / Guardian

Contact person information

First name

Last name

Email address

Phone / mobile number

Patient details (if different from contact person)

Patient full name

Patient date of birth / age

Visit address & location verification

Full home address

Postcode

Required to calculate service distance and travel fees.

Clinical history & recovery expectations

Primary area of care / service needed

Current complaints & short medical history

Patient goals & expectations from therapy

Current patient mobility status

Fully Independent (with or without walking aids)

Requires assistance from another person

Bedbound / Non-ambulatory

Transparent pricing & service fees

Initial Assessment & First Treatment 60 minutes£90.00
Comprehensive clinical examination, movement assessment, goal setting, immediate hands-on treatment, and a personalised recovery plan.
Follow-up Treatment Session 45 minutes£45.00
Targeted hands-on therapy, exercise progression, and functional mobility training.
Extended Follow-up Treatment Session 60 minutes£60.00
Comprehensive session ideal for complex neurological conditions, post-surgical care, or multi-site rehabilitation.

Important travel fee notice: the standard session fees listed above apply to appointments within Maidstone (ME16 8FE and immediate surrounding areas). For visits outside this primary coverage area, a nominal travel fee will be added based on the postcode provided in Step 1.

Payment terms & cancellation policy

Cashless practice & online prepayment

To reserve your dedicated home-visit slot, all initial bookings require upfront payment. We operate as a cashless practice and accept payments exclusively online via Debit/Credit Card, Apple Pay, or Google Pay at the time of booking.

Prepayment policy: Appointments are fully confirmed only upon completion of online checkout. Cash or cheques are not accepted.
24-hour cancellation & 100% refund guarantee: We understand that personal schedules change. If you cancel or reschedule your appointment at least 24 hours prior to your scheduled time, you will receive a 100% full refund with no penalty fees.
Late cancellations & missed visits: Cancellations or rescheduling requests made less than 24 hours before the appointment time, or missed visits upon clinician arrival, are non-refundable to cover allocated travel and clinical time.

I agree to the Booking, Travel Fee & Cancellation Policy: I understand that bookings are prepaid and cashless. Standard rates cover Maidstone, with travel surcharges applicable for extended distances verified by postcode. I acknowledge the 24-hour full refund cancellation window.

Privacy notice & data consent

Data protection & confidentiality

Your privacy and health records are protected under UK Data Protection Laws (UK GDPR) and Health and Care Professions Council (HCPC) standards. Information collected in this form is strictly utilised for clinical evaluation, booking management, and safe treatment planning. We will never sell or disclose your personal details to third parties. View our full Privacy Policy.

I consent to the collection and processing of my personal and health data for clinical care and booking management as outlined above.

Secure online payment

Choose the session you are booking below. Payment is taken online by Debit/Credit Card, Apple Pay or Google Pay when you press the button. The initial assessment & first treatment (60 minutes) is £90.00.

Session

Initial Assessment & First Treatment (60 minutes) – £90.00

Follow-up Treatment Session (45 minutes) – £45.00

Extended Follow-up Treatment Session (60 minutes) – £60.00

Your payment summary will appear here.

Pay with card, Apple Pay or Google Pay

Cancel or reschedule at least 24 hours before your visit for a 100% refund. Payments are processed securely by Stripe.

Book Your In-Home Physiotherapy Assessment

Contact & patient details

Clinical history & recovery expectations

Transparent pricing & service fees

Payment terms & cancellation policy

Privacy notice & data consent

Session fees

Need help with your booking?