Note we are operating with longer time between clients and potential different hours of operation to allow for us to continue to operate at our already high level of industry standards but to insure the extra measures with the guides linked above. We have a checklist for communication between the three businesses working with in our Wellness Center Side of the building. We have also closed off the partition door and are not cross contaminating with Family Chiropractic of Merrimack. Please note you will not be allowed to walk through the internal door for Chiropractic services and encourage you to seek use of their main door and observe the UNIVERSAL GUIDES when visiting them including but not limited to washing your hands on entry and mask wearing when receiving your adjustment. Thank you.
Waiver and Consent for TREATMENT: You will need to sign this as your waiver form one time and your health screening similar to that above for each visit, every time you see us a new screening is required. By accepting a treatment slot you agree to uphold all regulations set forth by the State of NH Governor, The Department of Health and Human Services (DHHS), and The Department of Business and Economic Affairs (BEA) in accordance with CDC and OSHA. COVID- 19 is a highly contagious virus that spreads easily from person to person. That said these best practices still offer no guarantee regarding the potential risk of being infected. I understand that due to the nature of the intimate physical close proximity and extended period of time with treatment services for self care there may be an elevated risk involved from receiving treatment at this time. I voluntarily agree to assume those risks and Release/Waive any and all liabilities of my practitioner/business from claims related thereto. I consent to treatment with new regulations and have honestly answered my health screening to what I know to be true. I consent to documentation of my visit for a contact tracing list should the need arise for a contagion tracking per any request from the state, hospital or other.
I had read and acknowledge this information and will comply with signing all required documentation to be eligible for services.