NOTE: Grant will be away training in Thailand until December 20.

COVID-19 Waiver

Sirius Health
Due to the COVID-19 pandemic, we are taking extra precautions with the intake of each client. Please answer these questions truthfully so we may continue to do our best to stop the spread.
Please help us serve you by completing this COVID-19 Waiver in advance.
Primary symptoms of COVID-19 may include:
  • new cough or a chronic cough that is worsening
  • fever
  • new or worsening shortness of breath or difficulty breathing
  • sore throat
  • runny nose
Secondary symptoms of COVID-19 may include:
  • stuffy nose
  • painful swallowing
  • headache
  • chills
  • muscle or joint pain
  • gastrointestinal symptoms
  • loss of sense of smell or taste
  • conjunctivitis (pink eye)
COVID-19 Waiver
COVID-19 Waiver
I accept the following affirmations when engaging in treatment from Sirius Health.

Name

Check all that apply:

Condition One
Condition Two
Condition Three
Condition Four
Condition Five
Condition Six
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