Clinical Conversations

Please visit www.cdc.gov/coronavirus/2019-ncov/downloads/Clinic.pdf

Nick Rinard is following all of the before patients arrive, when patients arrive and after patients are assessed safety protocols. Our staff is trained and prepared for our patients.

All patient must be able to check correct to all the questions in the below questionnaire to be seen and must consent to having temperatures taken at time of check in.

Nick Rinard Physical Therapy COVID-19 Safety Checklist:

Name:   __________________________________

I understand that Oregon and Washington have been doing their part in flattening the curve and that the COVID-19 emergency in local hospitals is beginning to improve.  With that in mind, I accept the risks of attending physical therapy by answering “✔” or ‘Correct” to all of the following:

I need this physical therapy appointment.                                                                  ✔      x

I attest that the benefit of physical therapy outweighs the risk of corona virus, at this time, in my case.                                    ✔         x

I do not or have not had flu-like symptoms within the last 2 weeks.                         ✔         x

I have not been exposed to others who were sick in the last 2 weeks.                        ✔         x

I do NOT have a fever.                              ✔  x                                                                 

I am in compliance with state “Stay Home, Save Lives” orders.                               ✔         x

I am complying with social distancing.   ✔        x                                                                   

I will wear a face cover when at physical therapy.                                                      ✔         x

I will wash/sanitize my hands before AND after physical therapy.                           ✔         x         

I agree that the clinic is doing its best to protect me and its staff.                             ✔         x

Clinic Temperature Reading (F°): ____________________

(Telehealth physical therapy online video appointments are still available to patients who feel it may be a better option – please contact our office for more information.)

Signed: ___________________________________      Date: ____________________