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COVID 19 Screening Questions & Procedures

Procedures for your upcoming visit

  1. Please review the questionnaire below.
  2. Please arrive on time and alone for your appointment, no additional people will be allowed in the clinic during your appointment.
  3. You will have your temperature checked prior to entry into the clinic.
  4. When you enter, please use the hand sanitizer next to the front entry.
  5. You will be directed to a desk where we will ask you to review, initial and sign a waiver for your visit (you will be required to complete this form for each individual visit).
  6. Once you have completed the form, you will leave it on the clipboard and you will be directed to the treatment area.
  7. Upon completion of treatment, you will exit through the rear clinic door.

COVID-19 Screening Questions

The safety of our patients and staff is of utmost importance to DNA Physical Therapy & Athletics. Given the recent COVID-19 outbreak, we have screening questions to review prior to your appointment. These are designed to help promote your safety as well as the safety of our staff and other patients. So that we can ensure that you receive care at the appropriate time and setting, please answer these questions truthfully and accurately. If you answer yes to any questions, please call our office to review your positive answers.

The following questions refer to both yourself and any members of your household:

  1. Have you or a member of your household had any of the following symptoms in the last 21 days: sore throat, cough, chills, body aches for unknown reasons, shortness of breath for unknown reasons, loss of smell, loss of taste, fever, temperature at or greater than 100 degrees Fahrenheit?
  2. Have you or a member of your household been tested for COVID-19?
  3. Have you or a member of your household been advised to be tested for COVID-19 by government officials or healthcare providers?
  4. Were you or a member of your household advised to self-quarantine for COVID-19 by government officials or healthcare providers?
  5. Have you or a member of your household visited or received treatment in a hospital, nursing home, long-term care, or other health care facility in the past 30 days?
  6. Have you or a member of your household traveled outside the US in the past 30 days?
  7. Have you or a member of your household traveled elsewhere in the last 21 days?
  8. Have you or a member of your household traveled on a cruise ship in the last 21 days?
  9. Are you or a member of your household healthcare providers or emergency responders?
  10. Have you or a member of your household cared for an individual who is in quarantine or is a presumptive positive or has tested positive for COVID-19?
  11. Do you have any reason to believe you or a member of your household has been exposed to or acquired COVID-19?
  12. To the best of your knowledge, have you been in close proximity to any individual who tested positive for COVID-19?