C-19 Protocols & Disclaimers
Due to the infectious nature of COVID-19, this additional intake form must be completed before each bodywork session. Please answer these questions truthfully and do everything asked so we can do our best to protect each other.

As a healthcare worker, I am committed to keeping you as safe and healthy as possible. The CO Dept of Regulatory Agencies (DORA) has issued the following protocols for Massage & Bodywork practices.
These precautions may seem awkward, and I apologize for the inconvenience, but they are meant to protect you & your loved ones.

Please know that people with COVID-19 can be asymptomatic and still be contagious. As of this writing (3/1/2021) there is no way to completely protect yourself from the virus, although the vaccine is a promising step. EVEN IF YOU HAVE BEEN VACCINATED, THESE PRECAUTIONS MUST STILL BE FOLLOWED. Take a look at the precautions I am taking on my website: http://www.souljournerhealingarts.com/corona-health-safety.
Email address *
Your full name: *
Symptoms Check - please reschedule your session if you are experiencing any of the following
Exposure *
Yes
No
Are you aware of having been exposed to
Have you travelled by air in the last 2 weeks?
Have you traveled to any places with a high infection rate, where people have not been isolating (no stay at home order), or been in any groups of people where social distancing was not observed?
Testing status (optional): Have you been tested for COVID, and/or for antibodies in the past month? If so, when, and what were the results?
Vaccination (optional) - if comfortable, share your vaccination status/progress (1 shot /both; amount of time since last shot).
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