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Service:
60 Min Well-BEing Session
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Staff:
Kelly Greenwell
Date/time:
Wed, Oct 24 2018 at 11:45 AM
(PDT)
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If you were referred, please let me know so that I can thank them and gift them with $10 off their next massage
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What brings you in for a massage? i.e. relaxation, neck/shoulder pain/tension, etc.
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COVID19: Have you had a fever in the last 24 hours of 100°F or above?
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COVID19: Do you now, or have you recently had, any respiratory or flu symptoms, sore throat, or shortness of breath?
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COVID19: Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus-type symptoms?
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COVID19: I understand that, because massage therapy work involves maintained touch and close physical proximity over an extended period of time, there may be an elevated risk of disease transmission, including COVID-19. By typing 'yes' in the space provided, I acknowledge that I am aware of the possible risks involved and give consent to receive massage and bodywork from this practitioner.
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