COVID-19 Screening Questionnaire

Before completing the questionnaire, please read through the following advice and conduct paragraphs.

At The Sussex Downs Fertility Centre all patients will be assessed prior to booking any appointments. The centre will not offer treatments to those with any major underlying health conditions.

Those attending the centre must self isolate for at least 7 days before attending the site. If you develop any symptoms or have been in contact with anyone who has any symptoms then please self-isolate and call the centre on 01323 410333 for further advice.

We will also start with the lowest risk services to start with e.g. semen analysis, initial consultations, frozen embryo transfers, IUIs. The patients who are approaching their age or funding cut off for their NHS cycles will be prioritised. These patients will be offered treatments first and only if they have successfully completed a screening questionnaire.

Please read: General advice on COVID-19

Please do not come to the fertility centre if you have either:

  • a high temperature of over 37.8 degrees – you feel hot to the touch on your chest or back
  • a new, continuous cough – this means you’ve started coughing repeatedly

Stay at home. Do not travel. Check the latest guidance at or contact your GP practice online, via app or by phone to be assessed.

If you need urgent medical help, use the NHS 111 online service.

If you cannot get help online, call 111.

If it’s a serious or life-threatening emergency, call 999.

To protect our patients and help prevent the spread of infection, we are not allowing additional people in our centre just those who have an appointment.

Please do not arrive early for an appointment and when you enter the centre use the hand sanitiser and wear a face mask.

Any visitor with a high temperature or a new, continuous cough will not be allowed into the centre.

Your health, safety and wellbeing and that of our patients, communities, individuals and teams across the organisation remain our absolute priority.

You can read more information in our FAQ on COVID-19 here

Read FAQ on COVID-19

Please read: Code of Conduct for Patients & Staff During Covid-19 Pandemic

It is our aim at The Sussex Downs Fertility Centre to provide a safe working environment for patients and staff during this pandemic.

To assist in providing this, all persons accessing the services of the centre are expected to observe the Code of Conduct highlighted below.

The SDFC Code of Conduct’s main aim is that people attending the SDFC, whether in person or by telephone, should behave in a manner that respects the rights of others and the centre environment.

We will require everyone to answer the questions on this questionnaire honestly and adhere to the guidelines issued around social distancing and wearing PPE in the centre.

The following is required of everyone visiting the centre:

  • Self-isolate for 7 days prior to your visit/appointment and continue throughout your treatment where possible
  • Complete the questionnaire on this page before any visit
  • Inform the centre immediately via telephone if your circumstances/condition changes or anyone close to you develops any of the symptoms by calling 01323 410333
  • Wear the PPE and wash your hands and use the hand sanitiser when you are in the centre
  • Maintain the 2m distance in the centre from other patients and visitors where possible

Any person acting in an unacceptable manner can be asked by a member of staff to stop behaving in such a way and to observe the Practice Code of Conduct.

If a person repeatedly fails to observe the Code of Conduct, the Practice could ask the patient to register elsewhere or refer the patient to the Challenging Behaviour Practice to receive his/her healthcare. The Practice will advise these arrangements to the patient in writing.

This screening questionnaire should  be completed no later than 48hrs prior to your appointment.

If you’ve already submitted a screening questionnaire more than 48hrs in advance of your appointment, we may ask you to resubmit a new questionnaire to provide more up-to-date information.

PLEASE NOTE: We understand that having treatment is a sensitive and emotional time for our patients, but until the pandemic situation de-escalates, we are asking all patients to attend their appointments alone to keep the number of patients in the centre down to a minimum to reduce the risk of possible infection and stay within social distancing guidelines. Thank you for understanding.