COVID-19 Screening - Corvallis Acupuncture & Wellness Center

Screening for COVID-19 and Clinic Policy

In these unprecedented times we are trying to establish a new normal at the clinic in order to ensure the safety and health of all of our patients and people working in the clinic. Please read our expectations and policy below, check the checkbox of each prompt, and sign at the bottom within 24 hours of every visit to the clinic.

What to know/do before your appointment:

Do not show up if you have any symptoms at all of being sick.
Do not show up if you feel you are considered in the “vulnerable” population
Bring a face mask. Practitioners will also be wearing a face mask.
Once you arrive please stay in your car. We will text you when we are ready for you to come in.
Once you come in, we will take your temperature or if you’d like, you can take your own temperature in the car and send us a picture.

Initials*
Please check each of these:*
- I have not been in contact with someone diagnosed with coronavirus (COVID-19) in the last 14 days
- In the last 14 days I have not had a fever greater than 100 degrees, had difficulty breathing or a cough
- I have not travelled out of the country within the last 14 days
- If I become infected by coronavirus (COVID-19) within 14 days of my last visit to Corvallis Acupuncture and I will contact the clinic to notify them.
- I understand Corvallis Acupuncture will keep a log of everyone who enters the clinic and will notify me if they suspect someone with coronavirus (covid 19) has been in the clinic with the last 14 days.
Signature*
Name
This field is for validation purposes and should be left unchanged.

107 SW 2nd St., Corvallis OR 97333
(541) 602-8172

Screening for COVID-19 and Clinic Policy

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