Good Morning -
I look forward to seeing you today at . Please review and respond to our COVID-19 Massage Appointment Prescreening Questionnaire below prior to your appointment. If you are a regular client and have previously responded to our questionnaire, you can either respond via email or verbally report your answers when you arrive for your appointment as long as there is nothing of concern indicated. If you need to reschedule your appointment, let me know ASAP.
COVID-19 Massage Appointment Prescreening Questionnaire:
Due to the infectious nature of COVID-19, especially in asymptomatic carriers, this Prescreening Questionnaire must be reviewed before each massage therapy session. Thank you for taking the time to answer these questions truthfully as we work together to keep each other safe during these interesting times. Feel free to ask me what things I am doing to create the safest environment possible for you at Hanover Massage.
Testing Status
1. Have you been tested for COVID-19? The antibody?
2. When? What were the results?
Vaccination Status
3. Have you received a COVID-19 vaccination? How many doses? When was your last one?
New/Recent Symptoms Unrelated to Another Health Concern
4. Are you experiencing Fever? (Please self report your temperature upon your arrival at Hanover Massage)
Cough?
Sore throat?
Shortness of breath?
Sudden loss of taste and smell?
Fatigue?
Chills?
Nasal or sinus congestion?
Sudden onset body aches?
New rash or other changes to your skin?
Exposure - In the Last 10 Days
5. Are you aware of any exposure to someone with COVID-19 or anyone who has been exposed to someone with COVID-19?
6. Is a member of your household currently in quarantine or isolation for COVID-19 or COVID-19 exposure? If yes, please explain the circumstances? Have they been tested? If yes, what was the result?
7. Have you done any air travel, domestic or international recently?
8. Have you traveled to any places with a high infection rate or been in any groups of people where social distancing was not observed?
9. Have you gathered socially with anyone who does not reside in the same household as you? Was it indoors? If yes, what precautions were taken?
Precautions
10. What precautions are/have you taken to limit your exposure to COVID-19?
11. Do you spend time around anyone considered high risk, such as elderly with comorbidities or immunocompromised family members?
Requested Actions
12. Are you willing to wash or sanitize your hands while at Hanover Massage?
13. Are you willing to wear a face mask at all times in my office and during the massage session? The only exception to this is when you are lying with your face in the cradle.
REMINDER:
New Office Location @ 2 Buck Road, Hanover NH - Buck Road is across from the Hanover Public Works Facility - 2 Buck Road is the first left on Buck Road
Once at 2 Buck Road, our office is in the first building on your left (ground level), enter through the door off the patio marked "B." Our new signage is up so look for "Hanover Massage" on both the parking lot sign as well as the window of our office. Please remain in your car and I will either step out of the office or text your cell phone, when I am ready for you.
See you soon!
Kind Regards,
Wendy
I look forward to seeing you today at . Please review and respond to our COVID-19 Massage Appointment Prescreening Questionnaire below prior to your appointment. If you are a regular client and have previously responded to our questionnaire, you can either respond via email or verbally report your answers when you arrive for your appointment as long as there is nothing of concern indicated. If you need to reschedule your appointment, let me know ASAP.
COVID-19 Massage Appointment Prescreening Questionnaire:
Due to the infectious nature of COVID-19, especially in asymptomatic carriers, this Prescreening Questionnaire must be reviewed before each massage therapy session. Thank you for taking the time to answer these questions truthfully as we work together to keep each other safe during these interesting times. Feel free to ask me what things I am doing to create the safest environment possible for you at Hanover Massage.
Testing Status
1. Have you been tested for COVID-19? The antibody?
2. When? What were the results?
Vaccination Status
3. Have you received a COVID-19 vaccination? How many doses? When was your last one?
New/Recent Symptoms Unrelated to Another Health Concern
4. Are you experiencing Fever? (Please self report your temperature upon your arrival at Hanover Massage)
Cough?
Sore throat?
Shortness of breath?
Sudden loss of taste and smell?
Fatigue?
Chills?
Nasal or sinus congestion?
Sudden onset body aches?
New rash or other changes to your skin?
Exposure - In the Last 10 Days
5. Are you aware of any exposure to someone with COVID-19 or anyone who has been exposed to someone with COVID-19?
6. Is a member of your household currently in quarantine or isolation for COVID-19 or COVID-19 exposure? If yes, please explain the circumstances? Have they been tested? If yes, what was the result?
7. Have you done any air travel, domestic or international recently?
8. Have you traveled to any places with a high infection rate or been in any groups of people where social distancing was not observed?
9. Have you gathered socially with anyone who does not reside in the same household as you? Was it indoors? If yes, what precautions were taken?
Precautions
10. What precautions are/have you taken to limit your exposure to COVID-19?
11. Do you spend time around anyone considered high risk, such as elderly with comorbidities or immunocompromised family members?
Requested Actions
12. Are you willing to wash or sanitize your hands while at Hanover Massage?
13. Are you willing to wear a face mask at all times in my office and during the massage session? The only exception to this is when you are lying with your face in the cradle.
REMINDER:
New Office Location @ 2 Buck Road, Hanover NH - Buck Road is across from the Hanover Public Works Facility - 2 Buck Road is the first left on Buck Road
Once at 2 Buck Road, our office is in the first building on your left (ground level), enter through the door off the patio marked "B." Our new signage is up so look for "Hanover Massage" on both the parking lot sign as well as the window of our office. Please remain in your car and I will either step out of the office or text your cell phone, when I am ready for you.
See you soon!
Kind Regards,
Wendy