Phoenix Rising

Healing Arts & Massage

Intuitive Healing Services for Mind, Body, Heart, & Soul

Home
COVID - 19 Response
Book Now
Gift Certificates
Services
More

Session Pre-screen Procedures

Per the State this screening questionnaire will need to be completed and on file for all clients within 24 hours prior to their scheduled appointment. If you have any questions on the questions or your responses please email or text Lauren directly (603.203.4777 for texting) and discuss this. Due to having a one-woman operation I am asking you to complete this electronically to assist in managing this requirement. Upon arrival for your session you will need to complete another health screening survey. I greatly appreciate your understanding and cooperation in keeping everyone safe as we proceed forward.

Pre-screening Questions prior to Appointments

In the last fourteen (14) days I have experienced the following (choose all that apply)

Fever 100.4 F or higher

Unexplained body aches or pain

Coughing

Sore Throat

Shortness of breath

Chills with or without body aches

Recent loss of sense of smell or taste

Unusual fatigue

Non-allergy related runny nose

NONE OF THE ABOVE

In the last fourteen (14) days I cetify that I have:

Had close contact with someone who is confirmed or suspected of being positive for COVID -19

Traveled outside the U.S.

Traveled on a cruise ship

Traveled domestically outside of NH, ME, or VT on public transportation (bus, train, plane, taxi/Uber, etc)

NONE OF THE ABOVE

By checking off each of these following items you are agreeing to follow the new MANDATORY protocols put into place effective JUNE 1, 2020 as a response to the on-going COVID-19 situation. Additional protocols are detailed on the website here.

I agree to take my body temperature the day of my scheduled appointment to ensure it is below 100.4F.

I agree to provide my own face covering/mask and that I will need to wear it upon arrival at the office, during the full appointment session, and upon exit from the office into community areas.

I agree to arrive NO EARLIER than FIVE (5) MINUTES prior to my scheduled start time. If I arrive early I will wait in my car. Upon entering the office I will head directly to the treatment room.

I certifiy that I am providing accurate health information at the time of completing this form. I agree that if I develop any of the symptoms for COVID-19 before and day of my appointment I will contact the office to reschedule. I agree that I have read Phoenix Rising's published COVID-19 protocols and agree to follow them. View COVID-19 Protocols Here.

Thank you and see you soon!

Back to Top

Follow us

© 2020 by Phoenix Rising Healing Arts & Massage