PLEASE REVIEW THE FOLLOWING SCREENING QUESTIONS
PRIOR TO YOUR APPOINTMENT
COVID-19 Screening Questionnaire:
- Are you fully vaccinated?
–If you answered “no” to question 1: - Have you or anyone in your household had any of the following symptoms in the last 14 days: sore throat, cough, chills, body aches for unknown reasons, shortness of breath for unknown reasons, loss of smell, loss of taste, fever at or greater than 100.4 degrees Fahrenheit?
- Are you or anyone in your household awaiting a test result? Or have you/they tested positive for COVID-19?
- Have you or anyone who is not fully vaccinated in your household traveled outside the country?
– If “yes,” how long ago? (Travelers should follow the guidelines of the state or country they visit. These rules may be different state by state or country by country.) - Have you or anyone in your household cared for an individual who is in quarantine or is a presumptive positive or has tested positive for COVID-19?
- Do you have any reason to believe you or anyone in your household has been exposed to or been in close proximity to anyone who tested positive for COVID-19?
Pelvic Health, a specialty physical therapy practice, is a therapist-owned private practice where you will receive personalized, one-on-one care in a relaxed, yet professional environment. We will team with both you and your other healthcare providers to develop and implement a comprehensive treatment plan.
Your treatment plan may include a variety of manual therapy techniques, behavioral therapy, therapeutic exercise, modalities including electrical stimulation, heat/ice and neuromuscular re-education including the use of biofeedback. We will work with you; within your comfort level, time constraints and any financial concerns to provide the best care possible to restore your pelvic health.
