Screening Checklist for Clients
Following questions will be asked of all individuals entering our clinic.
Name of the Individual
1. Have you had close contact with anyone with an acute respiratory illness?
2. Have you had any of the following symptoms in the past 14 days?
Shortness of Breath
Persistent Pain in the Chest
Unexplained fatigue/malaise/muscle aches (myalgias)
Nausea/vomiting, diarrhea, abdominal pain
3. Please check your temperature and enter the result.
4. Have you been in contact with people that were infected, suspected or diagnosed with COVID-19?
5. If you are 70 years of age or older, are you experiencing any of the following symptoms: delirium, unexplained or increased number of falls, acute functional decline, or worsening of chronic conditions?
Please Remember To:
Wash you hands or use antiseptics before entering our clinic.
Be prepared to wear a fask mask upon entering the building and during your massage.
Thank you so much!
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