In-person sessions are suspended until the widespread community outbreak in Rutland County has passed. Virtual Pilates and self-care sessions are a great alternative in the meantime, try one!
See below for the consent form for in-person sessions.
Sanitation procedures include:
· Between each client and at the start and end of each day, use of sanitizer on all surfaces that you will or may come into contact with, including but not limited to: face cradle and face cradle base, floor beneath the face cradle, massage table, ledge and table where you place personal items, lotion bottle, and all doorknobs, railings, handles in: hallway, bathroom, entryway, and massage office.
· Lysol or similar product is sprayed before and after each client in massage and Pilates office. Windows are opened as weather permits.
· Face masks are worn by all parties at all times.
· Talking will be limited during sessions to necessary communications.
· Clients are expected to maintain current social distancing guidelines and mandates as outlined by the State of Vermont, including the recommendation to wear a mask in public. Clients who choose not to socially distance as per current guidelines and/or who are not wearing masks in public are requested to socially distance for two weeks prior to session or services will be refused.
· In order to maintain an environment of full and open consent, there is a no-penalty cancellation policy. Given that COVID-19 information changes sometimes for one day to the next, you will never be charged if you change your mind about your comfort level in receiving a massage or if you have even a remote health concern about receiving massage. You may also change your mind during a session.
· While open communication and full consent has always been a policy and practice at Wolf Healing Arts, there is an increased need for the most explicit communication and reassurance in this time.
· I affirm that I understand that if after reading this information and consent form, I decide not to participate in massage therapy, I may leave with no financial penalty. I also understand that if I cancel any session with or without notice due to any COVID-19 related reason there will be no financial penalty.
HEALTH QUESTIONAIRE AND CONSENT FORM
COVID-19 Related Questions: All questions must be answered, or services will be refused.
1) Have you had a fever in the last 48 hours of 100°F or above? Yes ☐No ☐
2) Do you now, or have you recently had, any respiratory or flu symptoms, sore throat, or shortness of breath? Yes ☐ No ☐
3) Do you have any new loss of taste or smell? Yes ☐ No ☐
4) Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus-type symptoms (any respiratory or flu symptoms, sore throat, or shortness of breath)? Yes ☐ No ☐
5) Are you unable to exercise to get your heart rate and respiratory rate up without any problem? Yes ☐No ☐
6) Have you had a new onset of muscle aches and pain since the emergence of the virus? Yes ☐ No ☐
7) Have you seen any new marks, rashes, spots, bumps, or other lesions on your skin? Yes ☐ No ☐
It is my choice to receive massage therapy. I am aware of the benefits and risks of massage and give my consent for massage. I have read and understood the precautions and sanitary measures taken by Wolf Healing Arts in this form. I also understand that no precaution is guaranteed to completely protect against COVI-19 in a close contact setting. Otherwise stated, I understand that I may contract COVID-19 in a close contact setting even with precautionary measures taken. I understand that there is no implied or stated guarantee of success of effectiveness of individual techniques or series of appointments. I acknowledge that massage therapy is not a substitute for medical care, medical examination, or diagnosis. I have stated all medical conditions that I am aware of and will inform my practitioner of any changes in my health status.
Name (printed) ____________________________________