COVID 19 QUESTIONNAIRE; PLEASE ANSWER AND RETURN 24 HOURS BEFORE YOUR TREATMENT TO Healing@sylviashirley.com

Thank you very much for taking a few minutes to answer the Covid 19 Questionnaire and for returning it to me.
Have a very enjoyable day.

Please answer the questions with yes or no and return to Healing@sylviashirley.com 24 hours before your appointment, thank you very much.

Do you have or have had in the past 24 hours one or more of the following symptoms: nose cold, cough, sore throat, shortness of breath, and/or fever (from 38 degrees Celsius)?

Do you have a room mate/family member currently with a fever and/or shortness of breath?

Have you had the coronavirus (diagnosed with a laboratory test) and has it been diagnosed in the past 7 days?

Did you have a housemate/family member with the coronavirus (determined by a laboratory test) and did you have contact with this housemate/family member less than 14 days ago while he/she still had symptoms?

Are you in home isolation because you have had direct contact with someone who has been diagnosed with the coronavirus?

Anything else I should be aware of?

All the very best,

Sylvia

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