I understand that I will wash my hands and wear a mask upon the Physical Therapist's arrival
Please select any and all of the following which you have experienced in the past 14 days: *
If you have experienced any of options 1-4, please do not have the Physical Therapist come to your home **late cancellation fees will be waived in these cases
I have read each symptom and circumstance above and confirm that I have NOT experienced any of the symptoms or situations: * *