Please complete the medical questionnaire 24 hours prior to your first in person session. In person sessions are now available on a limited basis.

Medical Questionnaire

Please share the following information about you & your health. Your information is confidential. Please Inform Stephanie of any changes in your health between now and your scheduled sessions.

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Are you currently suffering from a medical condition, communicable disease, illness, or injury? Have you been hospitalized in the last 12 months?
Have you had a fever in the last 24 hours of 100°F or above?
Do you now, or have you recently had, any respiratory or flu symptoms, sore throat, or shortness of breath?
Do you now, or have you recently had, any chills, muscle aches, new loss of taste or smell, or new rashes or lesions?
Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus-type symptoms?
Are you able to take your temperature before my arrival? (if no, I may take your temperature upon arrival)
Masks must be worn by Client & Therapist for in person sessions. Do you have a mask to wear during your session? If no, a mask may be provided for you.

Sucessfully Submitted, Thanks!