Important Notice Regarding COVID and In-Office Visits

IN-PERSON SERVICES DURING COVID-19 PUBLIC HEALTH CRISIS
Risks of Opting for In-Person Services

Understand that by coming to the office, you are assuming the risk of exposure to the coronavirus (or other public health risk). This risk may increase if you travel by public transportation, cab, or ridesharing service.

Make sure your appointment has been flagged as In-Office. If not, we will assume you are telemedicine.

PLEASE ARRIVE 10 MINUTES EARLY as there are consent to treat forms that must be signed before you can enter the office.

Your Responsibility to Minimize Your Exposure

To obtain services in person, you will need to agree to take certain precautions which will help keep everyone (you, me, and our families, [my other staff] and other patients) safer from exposure, sickness and possible death. If you do not adhere to these safeguards, it may result in our starting / returning to a telehealth arrangement. For an In-Office visit, we ask that you adhere to the following:

• You will only keep your in-person appointment if you are symptom free.
• You will take your temperature before coming to each appointment. If it is elevated (99.9 Fahrenheit or more), or if you have other symptoms of the coronavirus, you agree to cancel the appointment or proceed using telehealth. If you wish to cancel for this reason, I won’t charge you our normal cancellation fee.
• You will call us upon your arrival and wait in your car in front of the office 10 minutes before our appointment time.
• Our staff will take your temperature before entering the office and you will be required to sign a consent to be treated In-Office
• You will wash your hands or use alcohol-based hand sanitizer when you enter the building.
• You will not sit in the waiting room or leave a child in the waiting room.
• You will wear a mask in all areas of the office (I [and my staff] will too).
• You will keep a distance of 6 feet and there will be no physical contact (e.g. no shaking hands) with me [or staff].
• You will try not to touch your face or eyes with your hands. If you do, you will immediately wash or sanitize your hands.
• If you are bringing your child, you will make sure that your child follows all of these sanitation and distancing protocols and wears a mask (age 3 and up)
  You will take steps between appointments to minimize your exposure to COVID.
• If you have a job that exposes you to other people who are infected, you will immediately let me [and my staff] know.
• If your commute or other responsibilities or activities put you in close contact with others (beyond your family), you will let me [and my staff] know.
• If a resident of your home tests positive for the infection, you will immediately let me [and my staff] know and we will then [begin] resume treatment via telehealth.

If you have tested positive for the coronavirus, we may be required to notify local health authorities that you have been in the office. If we have to report this, we will only provide the minimum information necessary for their data collection and will not go into any details about the reason(s) for our visits.

Office Safety Precautions in Effect During the Pandemic

My office is taking the following precautions to protect our patients and help slow the spread of the coronavirus.

• Waiting room is closed.
• My staff and I wear masks.
• My staff maintains safe distancing.
• Restroom soap dispensers are maintained and everyone is encouraged to wash their hands.
• Hand sanitizer that contains at least 60% alcohol is available in the therapy/testing rooms, the
  waiting room and at the reception counter.
• We schedule appointments at specific intervals to minimize the number of people in the waiting
  room.
• We ask all patients to wait in their cars or outside until no earlier than 5 minutes before their
  appointment times.
• Credit card pads, pens and other areas that are commonly touched are thoroughly sanitized
  after each use.
• Physical contact is not permitted.
• Tissues and trash bins are easily accessed. Trash is disposed of on a frequent basis.
• Common areas are thoroughly disinfected at the end of each day.