This document contains important information about our joint decision to engage in in-person services in light of the COVID-19 public health crisis. Please read this carefully and let us know if you have any questions. When you sign this document, it will be an official agreement between us.

We have mutually agreed to meet in-person for some or all future therapy, evaluation, behavioral coaching, and/or consultation services (the “services”). If there is a resurgence of COVID-19 or if other health concerns arise, Wolff Child Psychology (WCP) may require that we meet via telehealth (if feasible and clinically appropriate). If you have concerns about meeting via telehealth, we will talk about it first and try to address any issues. You understand that, if WCP believes it is necessary, WCP may determine to proceed via telehealth or to reschedule in-person services for a future date. We will provide services via telehealth if you decide at any time that you would feel safer doing so as long as it is feasible and clinically appropriate. Please note that coverage of telehealth services is subject to applicable law and is determined by your health plan.

You understand that COVID-19 is a contagious respiratory illness and that the President of the United States and state and local government officials have declared emergencies at various times related to COVID-19. You further understand that COVID-19 is extremely contagious and is believed to be spread by person-to-person contact. You also understand that it is believed that the virus can live on and be transmitted through contact with surfaces. While WCP has taken what it, in its sole discretion, deems to be commercially reasonable steps to attempt to prevent its employees, staff, and clients from contracting the virus at WCP’s offices, you understand that you are electing to enter the office and to receive in-person services, at your own risk notwithstanding any actions or inactions taken by WCP. Further, you understand and acknowledge that WCP, by taking any steps that it deems reasonable, is not assuming any duties to you or anyone related to you. You understand that you are assuming the risk of exposure to or becoming infected by COVID-19 (or other public health risk) by being at WCP’s office and receiving the in-person services. This risk may increase if you travel by public transportation, taxi, or a ridesharing service.

As a condition to obtaining in-person services, you agree to take the following precautions which will help reduce the risk of exposure to COVID-19, sickness, and possible death. If you do not adhere to these safeguards, it may result in WCP transitioning your services to a telehealth arrangement.

Initial each of the following safeguards to indicate you understand and agree to taking these precautions:

WCP has taken reasonable steps to reduce the risk of spreading COVID-19 within its offices and we have posted our efforts on our website, at the end of this form, and in the office. You understand and acknowledge that WCP, by taking any steps that it deems reasonable, is not assuming any duties to you or anyone related to you. Please let us know if you have questions about these efforts.

You understand that WCP is committed to reducing the risk of COVID-19 exposure in our offices. If we believe that the client has a fever or other symptoms or believe that you or others in your household have been exposed, we will require you to leave the office immediately. We can follow up with services by telehealth as appropriate and/or resume in-person services at an appropriate time in the future as determined by WCP in WCP’s sole discretion.

If you test positive for COVID-19, we may be required by law to notify the appropriate public health authorities. In such a scenario, we will only provide the minimum information necessary and will not disclose any details about your treatment or the reason(s) for our visits. WCP may disclose this information to a public health authority without an additional signed release.

WCP is taking the following safety precautions to protect our staff and clients, as well as the broader community, and to help slow the spread of COVID-19

General Safety Precautions

• Our waiting room has two pairs of chairs spaced more than 6 feet apart. These chairs are dedicated to the client's parents/guardians. No siblings are allowed to stay in the waiting room at this time. Parents are required to wear masks at all times while in the building.

• No physical contact between persons who are not of the same household is permitted at any time, and social distancing of a minimum of 6 feet is required at all times.

• Clients will be asked to track their symptoms daily starting 7 days prior to their initial appointment, and during any intervening days between appointments. Should the child have a temperature at or above 100° F during that time, parents or guardians must inform the staff so that alternate arrangements can be made (i.e., telehealth or rescheduling for a future time). Each child’s temperature will also be taken upon entry to the building.

• Offices will be cleaned and sanitized by WCP staff between each client. The whole building will be thoroughly cleaned by professional cleaners weekly.

• Two therapy/evaluation offices have been retrofitted with a floor-to-ceiling, wall-to-wall glass partition. The Denver Dept. of Public Health and Environment (DDPHE) has notified WCP, in writing, that the glass partition effectively splits each singular office into two distinct offices, allowing for each person to be safe without wearing a face mask. As such, a person on each side of the glass wall can follow the City of Denver Face Covering Order statute:

  Per the city’s Face Covering Order 4.C.i: “When a person is in a personal office (a single room) where others outside of that person’s household are not present as long as the public does not regularly visit the room, but that individual must put on a Face Covering when coworkers are working within six feet, when being visited by a client/customer, and anywhere members of the public or other coworkers are regularly present.”

   

  Per the DDPHE written notice to WCP: “If a clear wall is placed up to make two different rooms … the individuals in the two rooms would not be required to wear a face covering while in the single rooms.”

   

   

  Building Entry

• Upon entry to the building, WCP staff, clients, and parents/guardians will be required to wear masks, until they reach their enclosed office space, at which time they can remove the mask safely.

• Start times of clients will be staggered to allow for social distancing. Staff will arrive before clients to sanitize and set up the space.

• A hand sanitizer station has been placed at the building entry point, and clients and parents/guardians will be required to use it before proceeding to their assigned office.

• Each child’s temperature will be taken using a touchless thermometer by the staff upon entry (though a few minutes in a cool area may be required to allow for an accurate reading).

   

  Office Spaces

• The child’s and staff's spaces are each fitted with a comfortable chair in one place, and a desk and office chair in another, to allow for flexibility in seating depending on the service (e.g., evaluation, therapy).

• Each side will be sanitized by the staff using disinfectant wipes and/or sprays prior to each child’s appointment.

• Each side will have its own trash can, tissue box, alcohol-based hand sanitizer, disposable pens and pencils, disinfectant wipes, disposable face mask (in case the child does not have their own), and factory sealed bottles of water. For evaluations specifically, each child and staff will also have a disinfected laptop, iPad, and the relevant set of paper booklets on the desk.

• The child may be asked to utilize other assessment tools (e.g., toys, laminated papers, etc.) during therapy or evaluation. If so, those items will be sanitized prior to and after the child uses them.

• Each side has been fitted with appropriate HVAC systems for heat and cooling (i.e., either a vent from the main HVAC system, or a portable A/C unit and space heater).

• Each side, as well as the space outside the restroom, has been fitted with its own Coway AP-1512HH Air Purifier with True HEPA. The True HEPA filter is designed to capture 99.97% of airborne allergens and contaminants as small as 0.03 microns in size. According to the National Institute of Health, coronavirus particles are approximately .125 microns in size.

• In addition to the 5 Coway HEPA air purifiers, the building’s HVAC system has been fitted with a Reme Halo Whole-Home In-Duct UV Air Purifier, which is reported to kill up to 99% of bacteria, mold, and viruses.

• Each office space has been fitted with a high-quality sound system that will allow ease of verbal communication across the glass partition. Conversation will be able to be held at normal and natural volumes and tones.

   

  Restroom

• Clients and staff will be required to wear a mask to the restroom. Clients will be reminded to wash their hands thoroughly.

• The bathroom has been fitted with touchless fixtures, including the toilet, sink faucet, soap dispenser, and trash can. The paper towels are single use and thus a person only needs to use the untouched top towel.