Due to the 2019-2020 outbreak of the novel Coronavirus (COVID-19), Lactation Consultants of Central FL, LLC is taking extra precautions with the care of every client/patient/family/team member/provider to include health history review and enhanced sanitation/disinfecting procedures in compliance with CDC guidance.
Symptoms of COVID-19 include:
Fever or chills
Shortness of breath or difficulty breathing
Muscle or body aches
New loss of taste or smell
Congestion or runny nose
Nausea or vomiting
I agree to the following:
• I understand the above symptoms and affirm that I, as well as all household members, do not currently have, nor have experienced the symptoms listed above within the last 14 days.
• I affirm that I, as well as all household members, have not been diagnosed with COVID-19 within the past 30 days.
• I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19 within the past 30 days.
• I affirm that I, as well as all household members, have not traveled outside of the country or to any city considered to be a “hot spot” for COVID-19 infections within the past 30-days.
• I understand that Lactation Consultants of Central FL, LLC cannot be held liable for any exposure to the COVID-19 virus caused by misinformation on this form or the health history provided by each client.
Lactation Consultants of Central FL, LLC is following theses enhanced procedures to prevent the spread of COVID-19:
All Providers will:
Wear freshly laundered scrubs to very home visit.
Sanitize hands, phones, pen, teaching tools, scale, tools/equipment, and clipboard before and after every visit.
Wear a protective face covering. Offer to provide your family with face coverings.
Seek permission to wash hands upon entering your home.
Wear gloves throughout consultative visits (changing gloves after touching any surface/tool or patient).
Leave her shoes outside your home.
Maintain as much distance from the lactating parent and child as possible, while still providing essential care.
Refrain from directly touching patients (i.e. the lactating parent or child) with the exception of an oral, physical or breast exam which is deemed medically necessary and the patient’s consent (or their guardian) has been obtained.
By signing below, I agree to each statement above and release Lactation Consultants of Central FL, LLC from any and all liability for unintentional exposure or harm due to COVID-19.