YOU MUST COMPLETE THIS FORM BEFORE EVERY VISIT

  • In the past 14 days, I have experienced...
  • Prescreening Call

    Questions to ask a client in your day-before reminder/screening call:
    • Have you had a fever in the last 24 hours of 100°F or above?
    • Do you now, or have you recently had, any respiratory or flu symptoms, sore throat, or shortness of breath?
    • Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus-type symptoms?
    • If yes on any, reschedule without penalty.
    • Explain your revised Cancellation Policy and that there is no penalty if they wake up with cold or flu symptoms and need to cancel on day of, but to still notify you as soon as possible.
    • Take a minute to explain any new protocols as necessary, including the client’s wearing of masks as they arrive for their appointments. Does the client have a mask they can wear? Let them know you can provide a mask and describe to them how you want them to use it during their visit: have the mask on when entering the premises; together, you will evaluate their breathing comfort during the prone positioning portion of their massage session. The mask protocol is consistent with the CDC’s recommendation to the general public advising them to wear a cloth face covering whenever they must leave their home.