COVID-19 Safety Protocol

* Please click on this waiver link. Please print and sign waiver prior to your appointment.

If you do not have access to a printer, paper waivers are available at the office *

To our Patients

You will be required to fill out a disclosure form the day of your appointment.
You will have your temperature checked on entry for your appointment.
Payment for treatments can be made at reception desk, Venmo or via telephone.
Patients will be required to wear a mask at all times, except while lying in the prone position with your face in the face cradle.

Our Practitioners & Staff

Practitioners and Staff will have their temperature checked at the start of every shift.
Practitioners will wear masks at all times.
Practitioners will seek to receive routine Covid-19 tests.
The receptionist is located at a desk behind a glass window and will have limited interactions with patients.
To the extent staff will be required to interact with patients who were unable to fill out required documentation or make payments online, staff are required to wear fresh masks.

Cleaning

All cleaning will be done using CDC approved disinfectant, sanitizing sprays and wipes.
Medical Grade HEPA filters will be running in treatment rooms at all times, whether in use with patients or during cleaning period.
Each room will be thoroughly cleaned after each patient and will include (but is not limited to) cleaning the lotion bottles, doorknobs, changing the sheets on the treatment table and cleaning the treatment table.
As always, practitioners will thoroughly wash their hands.
The bathrooms and common areas will be cleaned after any usage by staff, practitioner, or patient.
Touchless soap and hand sanitizing stations will be placed in all common areas.

Covid-19 Patient Waiver

PATIENT DISCLOSURE STATEMENT

I, the undersigned, hereby attest that:

I have not engaged in any interstate or foreign travel within the last twenty (20) days; and
I do not currently have any symptoms of Covid-19 or other illness, including cough, fever, lethargy, shortness of breath or difficulty breathing, sore throat, or loss of taste or smell; and
To my knowledge, no person with whom I have had contact or been in proximity to, within the past fourteen days has experienced symptoms of Covid-19 or other illness (including cough, fever, lethargy, shortness of breath or difficulty breathing, sore throat, or loss of taste or smell)
I understand that falsifying information in this disclosure statement could lead to illness and injury to other persons and I take responsibility for the truth of this attestation.

Patient name ___________________________

Signature ______________________________

Date of treatment _______________________