Patient Informed Consent to Treatment During the COVID-19 Pandemic.

I am willing to complete the BC COVID-19 Symptom Self Assessment Tool within 24 hours of my treatment time and share with my therapist the results of this assessment.

I am willing to wear a facemask that covers both the mouth and nose, that is without an exhalation valve, within the treatment room at all times. If I do not have one, one will be provided for me.

I am committed to arriving at my appointment on time and will wait outside the clinic until such time.

Upon entering the clinic at my appointment time, I will wash my hands with soap and water for 20 seconds, or use the hand sanitizer provided, and wait until my hands are dry before touching any surfaces.

I understand that my massage therapist, Patricia Rambold, RMT is following a protocol to reduce or mitigate risk, but that risk cannot be reduced to zero, the fact that physical distancing is not possible in the treatment room, makes it impossible to reduce this risk to zero during the massage therapy treatment.

I consent to treatment today despite this risk of virus transmission.

In the event that I contact COVID-19 symptoms, I will notify the therapist immediately, and I allow for the release of my contact information to public health.