• Ultimate U Visit Health Questionnaire

    Wellness Services in the Era of COVI-19
  • If you have been exposed to a communicable disease, you may spread the disease to your Ultimate U service provider, other Ultimate U staff or other visitors to our facility.  To minimize that risk, State mandates require us to ask you the following questions prior to each visit. This typicallys takes about 10 seconds.

  • Do you or others accompanying you to your visit to Ultimate U today, or anyone you have recently been in contact with have any of the following symptoms?

  • Provide approximate dates of illness below.

  • Clear
  • Should be Empty: