Appointment Pre-screening Questionnaire for COVID-19

At Windrose Acupuncture safety is at the top of my priority list. In response to COVID-19 I have implemented  procedures designed to protect you, me, and our community. Please review the following questions prior to your upcoming Windrose Acupuncture appointment. If you respond Yes to any of these questions, please contact me prior to your appointment at 215-279-9137.

• Yes / No : In the last two weeks have you traveled 1) outside of the U.S. to countries that have been affected by COVID-19; or 2) domestically within the U.S. to a place where the number of COVID-19 is rising over the last two weeks; or 3) domestically within the U.S. by commercial airline, bus, or train?

• Yes / No : In the last two weeks have you had close contact with someone diagnosed or under investigation for COVID-19?

• Yes / No : Do you have a COVID-19 test result pending?

• Yes / No : Are you experiencing any of the following symptoms?

  • Fever (above 100.4) or feeling feverish (chills, sweating)

  • Chills

  • Cough

  • Sore throat

  • Muscle pain or body aches

  • Vomiting or diarrhea

  • Shortness of breath or difficulty breathing

  • Change in smell or taste