Consent Forms

Please complete the following forms prior to your visit.

Intake Forms

Health History

Consent Forms

Sensitive Area Consent Forms


** PLEASE READ **

We have new policies and provincial health standards in place to help keep you and our team safe during the current COVID-19 crisis. Please read the following statements. 

In the last 14 days, have you (or anyone in your house) had ANY of the following symptoms?

- Fever
- New onset of cough
- Worsening of a chronic cough
- Difficulty Breathing 
- Chills
- Fatigue
- Headaches (unrelated to reason for massage therapy treatment)
- New onset of runny or congested nose
- Loss of sense of taste or smell
- Difficulty swallowing
- Digestive issues (nausea/vomiting/diarrhea/stomach pain)
- in children - sluggishness or lack of appetite
- Pink eye (conjunctivitis)
- Sudden onset of malaise/muscle fatigue/myalgia (unrelated to reason for massage therapy treatment)

In the last 14 days, can you answer yes to ANY of the following statements?

- Have you been out of the province?
- Have you been to any areas of high concentration of COVID-19 cases?
- Has your work exposed you to known COVID-19 patients?
- Have you knowingly been in contact with someone who is COVID-19 positive?
- Are you (or anyone in your home) currently waiting for COVID-19 test results?

If you can answer YES to ANY of the above statements, we reserve the right to rebook your appointment to a later date (if you are booking an in-person appointment like massage.) Thank you all for helping to keep our Wellness Centre a healthy place.